Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MARK WEGMANN M.D.
NPI 1114095965
Internal Medicine - Gastroenterology in Metairie, LA

Q: What is Mark Wegmann's NPI number?

The NPI number for Mark Wegmann is 1114095965. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Q: What is Mark Wegmann's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Mark Wegmann was last updated on October 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.

Active since December 01, 2006PECOS EnrolledAccepts Medicare Assignment

79.87/100

CMS Quality Rating

4228 HOUMA BLVD, SUITE 520, METAIRIE, LA 70006(504) 456-8020(504) 456-8021 Get Directions Write a Review

NPPES record last updated: October 11, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Mark Wegmann M.d. NPPES

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

DR. MARK WEGMANN M.D. (NPI 1114095965) is an individual gastroenterology provider in Metairie, Louisiana, licensed in Louisiana (025641) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with West Jefferson Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (2001).

NPPES Registry Identity

NPI1114095965

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. MARK WEGMANNCredential: M.D.

Location Address4228 HOUMA BLVD, SUITE 520Metairie, LA 70006-3000

Mailing Address1111 Medical Center Blvd, Suite S-450Marrero, LA 70072-3151 · (504) 349-6423 · Fax (504) 349-6062

Phone(504) 456-8020

Fax(504) 456-8021

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2001

Enumeration DateDecember 1, 2006

Last NPPES UpdateOctober 11, 2026

✔ NPI 1114095965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in LA · 025641

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

4228 HOUMA BLVD, Metairie, LA 70006

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Other Identifiers 1

Medicaid04340LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark Wegmann 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 ID2961453303

PECOS Enrollment IDI20050203000080

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.

Medicare Billing Reassignments

Medicare enrollment records show Mark Wegmann reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

East Jefferson Physicians Group Urgent Care

4.6 mi

Urgent Care

708 W ESPLANADE AVE
Kenner, LA 70065

Reassigned Medicare billing, Louisiana enrollment
Medicare enrollment name: East Jefferson Physicians Group LLC
313 clinicians in this Medicare group

NPI 1053859082 (504) 503-5100

Administrators Of The Tulane Education Fund

7.0 mi

Anatomic Pathology & Clinical Pathology

2000 CANAL ST
New Orleans, LA 70112

Reassigned Medicare billing, Louisiana enrollment
Medicare enrollment name: Administrators Of The Tulane Educational Fund
851 clinicians in this Medicare group

NPI 1790354595 (504) 702-3000

Texas Digestive Disease Consultants PLLC

31 mi

Gastroenterology

131 CHEROKEE ROSE LN
Covington, LA 70433

Reassigned Medicare billing, Louisiana enrollment
92 clinicians in this Medicare group

NPI 1295428415 (214) 424-2200

South Louisiana Medical Associates

43 mi

Internal Medicine

1990 INDUSTRIAL BOULEVARD
Houma, LA 70363

Reassigned Medicare billing, Louisiana enrollment
189 clinicians in this Medicare group

NPI 1710944012 (985) 868-9300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 15

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

160 services121 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

106 services92 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

78 services74 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

43 services27 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

42 services42 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

36 services36 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

29 services28 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

27 services27 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

25 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

24 services24 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

23 services23 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

23 services23 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

16 services16 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

14 services14 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

West Jefferson Medical Center

Acute Care Hospitals · Marrero, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190039

Location1101 Medical Center BlvdMarrero, LA 70072 · Jefferson County

Emergency services Birthing friendly

East Jefferson General Hospital

Acute Care Hospitals · Metairie, LA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number190176

Location4200 Houma BlvdMetairie, LA 70006 · Jefferson County

Emergency services Birthing friendly

Leonard J Chabert Medical Center

Acute Care Hospitals · Houma, LA

OwnershipVoluntary non-profit - Other

CMS Certification Number190183

Location1978 Industrial BlvdHouma, LA 70363 · Terrebonne County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70006 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

$128.88 typical visit price

range $55.50 – $170.30

Typical copayment $32.22 (range $13.87 – $42.57)

Most-billed visit code 99204

Established Patient

$98.35 typical visit price

range $17.42 – $138.03

Typical copayment $24.58 (range $4.35 – $34.50)

Most-billed visit code 99214

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.

79.87/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.55

Promoting Interoperability

100

Improvement Activities

Cost

64.36

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

79%760 patients4/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

82%2,061 patients3/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

95%3,318 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

90%648 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

67%1,512 patients3/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

2%494 patients1/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

30%1,491 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 56% · 389 patients

Patients tobacco: 47% · 389 patients

5%37 patients1/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

63%1,512 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

15%1,512 patients2/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 494 patients

1%494 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

JACOB GENERAL SURGERY, LLC

Surgery

4228 HOUMA BLVD, SUITE 220
METAIRIE, LA 70006

Jefferson Parish (504) 264-9353

GARRETT WAX AGACNP-BC

Nurse Practitioner (Acute Care)

4228 HOUMA BLVD
METAIRIE, LA 70006

Jefferson Parish (504) 454-2222

BENNIE PETER NOBLES JR. MD

Obstetrics & Gynecology

4228 HOUMA BLVD, STE 410
METAIRIE, LA 70006

Jefferson Parish (504) 883-3770

MRS. DENISE CHATELAIN CRAWFORD R.N.F.A.

Registered Nurse (Registered Nurse First Assistant)

4228 HOUMA BLVD, SUITE 510
METAIRIE, LA 70006

Jefferson Parish (504) 454-0141

DR. JOHN F NITSCHE M.D.

Internal Medicine (Rheumatology)

4228 HOUMA BLVD, SUITE 600B
METAIRIE, LA 70006

Jefferson Parish (504) 454-2191

R. DANIEL JACOB, M.D.,A.P.M.C.

Otolaryngology

4228 HOUMA BLVD, SUITE 340
METAIRIE, LA 70006

Jefferson Parish (504) 454-3611

DR. RICHARD EDWARD BRIDGES M.D.

Family Medicine

4228 HOUMA BLVD, STE 200
METAIRIE, LA 70006

Jefferson Parish (504) 454-7878

MS. ERIN JIMINEZ NP

Nurse Practitioner (Family)

4228 HOUMA BLVD, STE 400
METAIRIE, LA 70006

Jefferson Parish (504) 889-5250

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 Mark Wegmann's NPI number?

The NPI number for Mark Wegmann is 1114095965. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Where is Mark Wegmann located?

Mark Wegmann practices at 4228 Houma Blvd Suite 520, Metairie, LA 70006. The listed phone number is (504) 456-8020.

What is Mark Wegmann's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Mark Wegmann enrolled in Medicare?

Yes. Mark Wegmann 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.

Which organizations bill Medicare for Mark Wegmann's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Wegmann reassigns Medicare benefits to 4 organizations: East Jefferson Physicians Group Urgent Care (Kenner, LA), Administrators Of The Tulane Education Fund (New Orleans, LA), Texas Digestive Disease Consultants PLLC (Covington, LA) and South Louisiana Medical Associates (Houma, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Wegmann's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Wegmann accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Mark Wegmann 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 Mark Wegmann affiliated with any hospitals?

According to CMS data, Mark Wegmann is affiliated with West Jefferson Medical Center, East Jefferson General Hospital and Leonard J Chabert Medical Center.

When was this NPI record last updated?

The NPPES record for Mark Wegmann was last updated on October 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.