Individual provider Active NPI

Erich J Weidenbener, M.D.

  • Sports Medicine (Internal Medicine) Physician
  • Bloomington, IN
National Provider Identifier
1811049380
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
01036915A Issued in IN
Practice address
541 S Landmark Ave
Bloomington, IN 47403-3239
Phone
(317) 455-1064
Fax
(317) 455-1204
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X 01036915A IN Primary

Addresses

Primary practice location

541 S Landmark Ave
Bloomington, IN 47403-3239

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407

Other practice location 1

6920 Gatwick Dr Ste 200
Indianapolis, IN 46241-9619
Phone (317) 455-1064

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
I20101112000670 IN Practitioner - Sports MedicinePractitioner - Internal Medicine 0840485082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Indiana University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Indiana Orthopedics LLCGroup PAC ID 5698667822, 148 clinicians

Practice addresses (Care Compare)

541 S Landmark Ave
Bloomington, IN 47403-3239
Phone (317) 455-1064

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
64.48
Promoting interoperability
96
Improvement activities
40
Cost
78.21

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Orthopedics, LLC CurrentSince Oct 11, 2023 Accepting new patients
Central Indiana Orthopedics LLC Sports Medicine CurrentSince Oct 11, 2023 Accepting new patients
Indiana MRI, LLC Past Accepting new patients

Locations

541 S Landmark Ave
Bloomington, IN 47403
Phone (317) 455-1064

6920 Gatwick Dr
Ste 200
Indianapolis, IN 46241
Phone (317) 455-1064

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

3051 S US Highway 41
Terre Haute, IN 47802
Phone (317) 455-1064

Interoperability endpoints

  • Direct secure messaging: erich.weidenbener.p4@direct.beaconortho.nextgenshare.com

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 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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1811049380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "317-455-1064",
            "fax_number": "317-455-1204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6920 Gatwick Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462419619",
            "country_code": "US",
            "telephone_number": "317-455-1064",
            "fax_number": "317-455-1204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIDENBENER",
        "first_name": "ERICH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "IN",
            "license": "01036915A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.