Individual provider Active NPI

Andrew Wieging, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1689104242
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082630A Issued in IN
Practice address
3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone
(260) 478-5135
Fax
(260) 478-5187
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11019460A IN
Family Medicine Physician 207Q00000X 01082630A IN Primary

Addresses

Primary practice location

3534 Brooklyn Ave
Fort Wayne, IN 46809-1361

Mailing address

3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone (260) 478-5135

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrew.wieging@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200622002470 IN Practitioner - Family Practice 8729357926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

2520 E Dupont Rd
Dupont Hospital
Fort Wayne, IN 46825-1675
Phone (260) 432-2297

3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone (260) 432-2297

702 Van Buren St
Fort Wayne, IN 46802-3697
Phone (260) 425-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01082630AINMDFamily Medicine Physician
11019460AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2020 Accepting new patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

Organizations & group practices 2

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1689104242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 BROOKLYN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091361",
            "telephone_number": "260-478-5135",
            "fax_number": "260-478-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 BROOKLYN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091361",
            "telephone_number": "260-478-5135",
            "fax_number": "260-478-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGING",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11019460A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082630A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.wieging@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3534 Brooklyn Ave",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468091361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.