Individual provider Active NPI

Casey Thomas Weitzel, PA-C

  • Physician Assistant
  • Charlevoix, MI
National Provider Identifier
1811658347
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone
(231) 547-4024
NPI assigned
Jan 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

14700 Lake Shore Dr
Charlevoix, MI 49720-1931

Mailing address

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 947-0673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220224002694 MI Practitioner - Physician Assistant 4284028804 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Michigan PCGroup PAC ID 0941511224, 40 clinicians
The Skin Cancer and Dermatology Center PLCGroup PAC ID 5597012096, 5 clinicians

Practice addresses (Care Compare)

13450 E 12 Mile Rd
Warren, MI 48088-3671
Phone (586) 759-5525

4170 Cedar Bluff Dr
Petoskey, MI 49770-7627
Phone (231) 487-2230

5199 N Royal Dr
Traverse City, MI 49684-9201
Phone 231486023012

Hospital & facility affiliations

  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
81.43
Promoting interoperability
82
Improvement activities
40
Cost
80.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Skin Cancer and Dermatology Center PLC CurrentSince Aug 28, 2025 Accepting new patients

Locations

502 Cobb St
Cadillac, MI 49601
Phone (231) 775-1248

5199 N Royal Dr
Traverse City, MI 49684
Phone (231) 486-0230

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 2

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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1811658347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-947-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZEL",
        "first_name": "CASEY",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.