Individual provider Active NPI

Michael Wemhoff, PA

  • Medical Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1720097314
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000377A Issued in IN
Practice address
5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701
Phone
(260) 432-1568
Fax
(260) 432-4969
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10000377A IN Primary

Addresses

Primary practice location

5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701

Mailing address

PO Box 80070
Fort Wayne, IN 46898-0070
Phone (260) 432-1568

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000336 IN Practitioner - Physician Assistant 0143389767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Radiology P CGroup PAC ID 0143295410, 101 clinicians

Practice addresses (Care Compare)

441 N Wabash Ave
Marion, IN 46952-2612
Phone (260) 432-1568

5001 US Hwy 30 W D
Fort Wayne, IN 46818-9701
Phone (260) 432-1568

7601 W Jefferson
Fort Wayne Orthopaedics
Fort Wayne, IN 46804-4133
Phone (260) 436-8686

7631 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone (260) 436-7770

7950 W Jefferson Blvd
Lutheran Hospital of Fort Wayne
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7952 W Jefferson Blvd
Orthopaedic Hospital of Lutheran Network
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7956 W Jefferson Blvd
120 Allied Imaging II
Fort Wayne, IN 46804-4140
Phone (260) 436-2416

7970 W Jefferson Blvd
Rehabilitation Hospital of Fort Way
Fort Wayne, IN 46804-4140
Phone (260) 435-6142

7988 W Jefferson Blvd
Summit Radiology/Womens Health Adva
Fort Wayne, IN 46804-4140
Phone (260) 432-1568

Hospital & facility affiliations

  • Woodlawn Hospital Hospital, Rochester, IN, CCN 151313
  • Marion General Hospital Hospital, Marion, IN, CCN 150011
  • Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
  • Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
92.18
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000377AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine of Indiana Past Accepting new patients
Baltes Cardiology Past Accepting new patients

Organizations & group practices 3

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1720097314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80070",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468980070",
            "telephone_number": "260-432-1568",
            "fax_number": "260-432-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 US HIGHWAY 30 W STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189701",
            "telephone_number": "260-432-1568",
            "fax_number": "260-432-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEMHOFF",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000377A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.