Individual provider Active NPI

Lawrence W Witzberger IV, PA-C

  • Physician Assistant
  • Wheeling, WV
National Provider Identifier
1932461100
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1636 Issued in WV
Practice address
10 Medical Park
Suite 206
Wheeling, WV 26003-6379
Phone
(304) 243-6534
Fax
(304) 243-8575
NPI assigned
Jun 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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 1636 WV Primary

Addresses

Primary practice location

10 Medical Park
Suite 206
Wheeling, WV 26003-6379

Mailing address

10 Medical Park
Suite 206
Wheeling, WV 26003-6379
Phone (304) 243-6534

Other identifiers 1

IdentifierTypeStateIssuer
0350220MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120918000479 WV Practitioner - Physician Assistant 4183872039 Reassigns benefits to 1 organization
I20250224002318 OH Practitioner - Physician Assistant 4183872039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
  • Harrison Community Hospital Hospital, Cadiz, OH, CCN 361311
  • Wetzel County Hospital Hospital, New Martinsville, WV, CCN 510072

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1636WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Aug 7, 2012 Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients
Wheeling Hospital Inc Past Accepting new patients

Locations

68 State Route 7
Bridgeport, OH 43912
Phone (740) 676-6600

222 N 5th St
Ste 101
Martins Ferry, OH 43935
Phone (740) 633-6480

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

10 Medical Park
Ste 206
Wheeling, WV 26003
Phone (304) 243-3384

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1932461100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "SUITE 206",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036379",
            "telephone_number": "304-243-6534",
            "fax_number": "304-243-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "SUITE 206",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036379",
            "telephone_number": "304-243-6534",
            "fax_number": "304-243-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZBERGER",
        "first_name": "LAWRENCE",
        "middle_name": "W",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0350220",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.