Michael Wieczorkowski, PA-C, ATC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17404 Issued in TX

Practice address

400 Concord Plaza Dr Ste 300
San Antonio, TX 78216-6991

Phone

(210) 804-5911

NPI assigned

Jun 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The San Antonio Orthopaedic Group LLPGroup PAC ID 6800798794, 143 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.86 of 100Reported as group

Quality

65.93

Promoting interoperability

94

Improvement activities

40

Cost

71.93

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.wieczorkowski.1@94.direct.athenahealth.com

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.

• The San Antonio Orthopaedic Group, LLP

  • Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1720022494
  Medicare reassignment Care Compare group NPD
• The San Antonio Orthopaedic Group, LLP

  • Orthopedic Physical Therapist
  • San Antonio, TX
  • NPI 1770042152
  NPD
• Greater Austin Allergy, Asthma & Immunology PA

  • Allergy & Immunology Physician
  • Round Rock, TX
  • NPI 1275978306
  NPD (past)
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1629506753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONCORD PLAZA DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166991",
            "telephone_number": "210-804-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONCORD PLAZA DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166991",
            "telephone_number": "210-804-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 S 8th Ave Stop 8253",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832090002",
            "country_code": "US",
            "telephone_number": "208-282-4726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIECZORKOWSKI",
        "first_name": "MICHAEL",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5781",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA17404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Wayne Widen, DC
• Lawrence Edward Widman, M.D.
• Ian Wiechers
• Alexandra Wiechmann, O.D.
• Dean Michael Wieczorek, D.O.
• Jordan Lewis Wiederstein, LPC
• Kristopher Wieland
• Abrana Wielgosiak
• Marcy R Wiemers, M.D.
• Nicole Wienecke, OTR

• Medical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.