Carlos A Wiegering, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD019247E Issued in PA

Practice address

200 Hospital Dr
Suite 3
Tyrone, PA 16686-1825

Phone

(814) 684-4472

Fax

(814) 684-4780

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1619974243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "address_2": "SUITE 3",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166861825",
            "telephone_number": "814-684-4472",
            "fax_number": "814-684-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "address_2": "SUITE 3",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166861825",
            "telephone_number": "814-684-4472",
            "fax_number": "814-684-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGERING",
        "first_name": "CARLOS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD019247E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005918710002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "441021880",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyrone Medical Associates
• Tyrone Medical Associates Specs
• Jolene C Umholtz
• Don Wagner
• Megan Wall, RD, LDN

• General Practice Physician in Tyrone, PA
• Providers in Tyrone, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.