NPIMap

Individual provider Active NPI

Patrick G Wetovick, M.D.

  • Family Medicine Physician
  • Cozad, NE
National Provider Identifier
1588680953
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NE20843 Issued in NE
Practice address
1803 Papio LN
Cozad, NE 69130-1138
Phone
(308) 784-3535
Fax
(308) 784-3534
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NE20843 NE Primary

Addresses

Primary practice location

1803 Papio LN
Cozad, NE 69130-1138

Mailing address

1803 Papio Lane
PO Box 86
Cozad, NE 69130-0086
Phone (308) 784-3535

Other identifiers 1

IdentifierTypeStateIssuer
080165449MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000671 NE Practitioner - Family Practice 5092856302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cozad Community HospitalGroup PAC ID 6507810389, shared by 6 NPIs, 9 clinicians

Practice addresses (Care Compare)

300 E 12TH St
Cozad, NE 69130-1532
Phone (308) 784-2261

PO Box
Suite 108
Cozad, NE 69130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NE20843NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cozad Community Hospital Family Medicine CurrentSince Nov 18, 2011 Accepting new patients
Cozad Community Hospital Family Medicine CurrentSince Nov 18, 2011 Accepting new patients
Cozad Community Hospital Current Accepting new patients
Cozad Community Hospital Family Medicine Past Accepting new patients

Locations

1803 Papio Ln
Cozad, NE 69130
Phone (308) 784-3535

300 E 12th St
Cozad, NE 69130
Phone (308) 784-2261

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cozad Community HospitalCozad, NE, CCN 281327 Hospital W-2 Managing Employee
Operational/Managerial Control		 Apr 28, 2022
Apr 28, 2022
Cozad Community HospitalCozad, NE, CCN 28Z327 Hospital W-2 Managing Employee
Operational/Managerial Control		 Apr 28, 2022
Apr 28, 2022
Cozad Community Medical ClinicCozad, NE, CCN 288512 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Apr 28, 2022
Apr 28, 2022
Eustis Community Medical ClinicEustis, NE, CCN 288553 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Apr 28, 2022
Apr 28, 2022

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1588680953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 PAPIO LANE",
            "address_2": "PO BOX 86",
            "city": "COZAD",
            "state": "NE",
            "postal_code": "691300086",
            "telephone_number": "308-784-3535",
            "fax_number": "308-784-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 PAPIO LN",
            "city": "COZAD",
            "state": "NE",
            "postal_code": "691301138",
            "telephone_number": "308-784-3535",
            "fax_number": "308-784-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETOVICK",
        "first_name": "PATRICK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "NE20843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080165449",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cozad, NE

Sources for this page

Verify at the official NPI Registry.