Individual provider Active NPI

Kirsten Teaney Weiser, M.D.

  • Gastroenterology Physician
  • Fort Wayne, IN
National Provider Identifier
1588758270
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01081385A Issued in IN
Practice address
11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 46845
Phone
(260) 266-5230
Fax
(260) 266-5238
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 14241 NH
Gastroenterology Physician 207RG0100X 42-0010557 VT
Gastroenterology Physician 207RG0100X 2008-01383 NC
Gastroenterology Physician 207RG0100X 13660 SD
Gastroenterology Physician 207RG0100X 294978 NY
Gastroenterology Physician 207RG0100X 99004 GA
Gastroenterology Physician 207RG0100X 01081385A IN Primary

Addresses

Primary practice location

11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 46845

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

1139 Lexington Ave Ste A
Savannah, GA 31404-5502
Phone (912) 303-4200

Other identifiers 1

IdentifierTypeStateIssuer
5911911MedicaidNC

Other names 1

  • Dr. Kirsten Ursula Teaney Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kweiser194881@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221124000005 SD Practitioner - Gastroenterology 6305909656 Reassigns benefits to 2 organizations
I20240723001767 GA Practitioner - Internal Medicine 6305909656 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1139 Lexington Ave
Suite a
Savannah, GA 31404-5502
Phone (404) 257-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy27
Upper gastrointestinal (GI) endoscopy for acid reflux86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01081385AINMDGastroenterology Physician
14241NHMDGastroenterology Physician
42-0010557VTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Sep 19, 2023 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Sep 19, 2023 Accepting new patients
Aga, LLC Gastroenterology CurrentSince Jul 11, 2024 Accepting new patients
Aga Professional Services, LLC Gastroenterology CurrentSince Jul 1, 2024 Accepting new patients
Sanford Medical Center CurrentSince Sep 26, 2022 Accepting new patients

Locations

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

1000 Towne Center Blvd
Ste 701
Pooler, GA 31322
Phone (912) 303-4200

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1139 Lexington Ave
Ste A
Savannah, GA 31404
Phone (912) 303-4200

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Interoperability endpoints

  • Direct secure messaging: kweiser194881@direct.parkviewexchange.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations & group practices 6

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1588758270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR STE 310",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-266-5230",
            "fax_number": "260-266-5238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1139 Lexington Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314045502",
            "country_code": "US",
            "telephone_number": "912-303-4200",
            "fax_number": "912-790-2701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISER",
        "first_name": "KIRSTEN",
        "middle_name": "TEANEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NH",
            "license": "14241",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VT",
            "license": "42-0010557",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2008-01383",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SD",
            "license": "13660",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "294978",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "99004",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01081385A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911911",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kweiser194881@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "TEANEY",
            "middle_name": "URSULA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.