Individual provider Active NPI

Joseph P Wiedemer, MD

  • Family Medicine Physician
  • State College, PA
National Provider Identifier
1689648438
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD065285L Issued in PA
Practice address
1850 E Park Ave
State College, PA 16803-6706
Phone
(814) 235-2480
Fax
(814) 235-2482
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD065285L PA Primary

Addresses

Primary practice location

1850 E Park Ave
State College, PA 16803-6706

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 1

IdentifierTypeStateIssuer
7859104MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131127001243 PA Practitioner - Family Practice 9234254939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

143 Hospital Dr
Suite 207
State College, PA 16803-3200
Phone (814) 235-2480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Sep 14, 2013 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Family Medicine CurrentSince Sep 14, 2013 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Hunterdon Medical Center Past Accepting new patients

Locations

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

143 Hospital Dr
Ste 207
State College, PA 16803
Phone (814) 235-2480

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

1850 E Park Ave
Ste 207
State College, PA 16803
Phone (814) 235-2480

Organizations & group practices 4

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 6

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1689648438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-235-2480",
            "fax_number": "814-235-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMER",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD065285L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7859104",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.