Individual provider Active NPI

Lauren A. Wiebe, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Evanston, IL
National Provider Identifier
1811193592
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
036117764 Issued in IL
Practice address
2650 Ridge Ave.
Palliative Care
Evanston, IL 60201
Phone
(847) 503-4222
Fax
(847) 503-4220
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036117764 IL
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 036117764 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Palliative Care
Evanston, IL 60201

Mailing address

2650 Ridge Ave.
Palliative Care
Evanston, IL 60201-1718
Phone (847) 503-4222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwiebe262691@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20141110000057 IL Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Medical OncologyPractitioner - Hematology/Oncology 0749475960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Medical Oncology
Education
Columbia University College of Physicians and Surgeons, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Nov 10, 2016 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 10, 2016 Accepting new patients

Locations

1725 W Harrison St
Ste 955
Chicago, IL 60612
Phone (312) 563-3700

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2180 Pfingsten Rd
Glenview, IL 60026
Phone (847) 503-1000

Interoperability endpoints

  • Direct secure messaging: lwiebe262691@direct.northshore.org

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 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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1811193592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "PALLIATIVE CARE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-503-4222",
            "fax_number": "847-503-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "PALLIATIVE CARE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-503-4222",
            "fax_number": "847-503-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBE",
        "first_name": "LAUREN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036117764",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036117764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwiebe262691@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave.",
            "address_2": "Palliative Care",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.