Individual provider Active NPI

Alexander Weick, M.D.

  • Gastroenterology Physician
  • Traverse City, MI
National Provider Identifier
1942542444
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301116862 Issued in MI
Practice address
4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306
Phone
(231) 935-5710
Fax
(231) 935-9045
NPI assigned
Mar 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD27295 ME
Gastroenterology Physician 207RG0100X 4301116862 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345

Other practice location 1

161 Marginal Way
Portland, ME 04101-2438
Phone (207) 773-7964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190605002442 MI Practitioner - Gastroenterology 0648402693 Reassigns benefits to 2 organizations
I20230818001630 ME Practitioner - Gastroenterology 0648402693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7306
Phone (231) 935-5710

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy104
Upper gastrointestinal (GI) endoscopy for acid reflux222

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Associates of Northern Michigan, P.C. Gastroenterology CurrentSince Jul 1, 2019 Accepting new patients
Munson Medical Center CurrentSince Jul 8, 2024 Accepting new patients
Portland Gastroenterology Associates P.a. Gastroenterology CurrentSince Oct 1, 2023 Accepting new patients
Munson Medical Center Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4100 Park Forest Dr
Ste 208
Traverse City, MI 49684
Phone (231) 392-8705

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 6

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 6

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1942542444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR STE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847306",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Marginal Way",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041012438",
            "country_code": "US",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEICK",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-22",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD27295",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301116862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.