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DR. PAUL WETSTEIN M.D.
NPI 1104189166
Surgery in Champaign, IL

Active since June 24, 2012PECOS EnrolledAccepts Medicare Assignment
83.98/100
CMS Quality Rating
3105 FIELDS SOUTH DR, CHAMPAIGN, IL 61822(217) 383-3240 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 5, 2024, Jun 25, 2020 (2 updates tracked since 2020).

About Dr. Paul Wetstein M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL WETSTEIN M.D. (NPI 1104189166) is an individual surgery provider in Champaign, Illinois, licensed in Illinois (036166628) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and maintains a secondary practice location in Miami.

NPPES Registry Identity

NPI1104189166
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. PAUL WETSTEINCredential: M.D.
Location Address3105 FIELDS SOUTH DRChampaign, IL 61822-3743
Mailing Address3105 Fields South DrChampaign, IL 61822-3743 · (217) 383-3240
Phone(217) 383-3240
Sole ProprietorNo
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 2012
Enumeration DateJune 24, 2012
Last NPPES UpdateMarch 5, 20242 updates tracked since enumeration
NPPES CertifiedMarch 5, 2024
✔ NPI 1104189166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036166628
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X · License ME135643 (FL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3105 FIELDS SOUTH DR, Champaign, IL 61822
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Secondary Practice Location 1

Location 11800 NW 10th AveMiami, FL 33136-1018 · Phone (305) 585-1179 · Fax (305) 585-1180

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross Blue Shield of North Dakota, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Paul Wetstein M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517377724
PECOS Enrollment IDI20201029000403, I20231221002085
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
27 services21 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Carle Foundation Hospital

Acute Care Hospitals · Urbana, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140091
Location611 West Park StreetUrbana, IL 61801 · Champaign County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61822 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.98/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.28
Promoting Interoperability99
Improvement Activities40
Cost68.15

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABBIGAIL KIRCHNER AU.D.
Audiologist
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-4327
DR. KELLY CUNNINGHAM MD
Otolaryngology
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-3277
PETER ALEX SHIREMAN
Audiologist
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-3937
DR. JACOB A. STELLE M.D.
Otolaryngology
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-3277
SAAD AL-KADHI M.D.
Ophthalmology
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-3937
NICHOLAS MECHAS D.M.D.
Dentist (Oral and Maxillofacial Surgery)
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 900-2527
ABU-BAKAR ZAFAR M.D.
Ophthalmology
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (217) 902-3937
CARLE HEALTH CARE INCORPORATED
Durable Medical Equipment & Medical Supplies
3105 FIELDS SOUTH DR
CHAMPAIGN, IL 61822
Champaign County (179) 023-9372

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Wetstein's NPI number?

The NPI number for Paul Wetstein is 1104189166. It was assigned to this individual provider in the NPPES registry on June 24, 2012.

Where is Paul Wetstein located?

Paul Wetstein practices at 3105 Fields South Dr, Champaign, IL 61822. The listed phone number is (217) 383-3240.

What is Paul Wetstein's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Paul Wetstein enrolled in Medicare?

Yes. Paul Wetstein is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Paul Wetstein accept?

Health plans from AmeriHealth Caritas Next, Blue Cross Blue Shield of North Dakota, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Medica and 3 other insurers list Paul Wetstein as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Wetstein affiliated with any hospitals?

According to CMS data, Paul Wetstein is affiliated with Jackson Health System and Carle Foundation Hospital.

When was this NPI record last updated?

The NPPES record for Paul Wetstein was last updated on March 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.