Individual provider Active NPI

Joanna Wieckowska, DO

  • Pulmonary Disease Physician
  • Muskegon, MI
National Provider Identifier
1659860872
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5101028236 Issued in MI
Practice address
1560 E Sherman Blvd
Ste 250
Muskegon, MI 49444-1854
Phone
(231) 672-6186
Fax
(231) 672-6181
NPI assigned
May 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101023799 MI
Pulmonary Disease Physician 207RP1001X 5101028236 MI Primary

Addresses

Primary practice location

1560 E Sherman Blvd
Ste 250
Muskegon, MI 49444-1854

Mailing address

PO Box 776982
Chicago, IL 60677-6982
Phone (800) 494-5797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20240806004393 MI Practitioner - Pulmonary Disease 2062756505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Partners Sub-Specialty ServicesGroup PAC ID 3274504105, 33 clinicians

Practice addresses (Care Compare)

1560 E Sherman Blvd
Suite 250
Muskegon, MI 49444-1854
Phone (231) 672-8145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.79 of 100Reported as group
Quality
96.38
Improvement activities
40
Cost
77.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023799MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners Sub-Specialty Services Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

1310 Wisconsin St
Ste 200
Grand Haven, MI 49417
Phone (616) 296-1640

1277 Mercy Dr
Slp Ctr
Muskegon, MI 49444
Phone (231) 672-6186

1560 E Sherman Blvd
Ste 250
Muskegon, MI 49444
Phone (231) 672-8145

Interoperability endpoints

  • Direct secure messaging: jwieckowska2491519@direct.trinity-health.org
  • Direct secure messaging: jwieckowska984959@direct.hfhs.org

Organizations & group practices 1

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 3

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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1659860872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776982",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776982",
            "telephone_number": "800-494-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E SHERMAN BLVD",
            "address_2": "STE 250",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441854",
            "telephone_number": "231-672-6186",
            "fax_number": "231-672-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECKOWSKA",
        "first_name": "JOANNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101023799",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "5101028236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.