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

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: November 14, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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 UpdateNovember 14, 2013
✔ 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 3

Medicaid04340LA
Medicare UPINI24539LA
Medicare PIN4J314LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.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. 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.

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

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
Quality68.55
Promoting Interoperability100
Improvement Activities40
Cost64.36

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. THORKELL EINARSSON MD
Student in an Organized Health Care Education/Training Program
4228 HOUMA BLVD
METAIRIE, LA 70006
Jefferson Parish (504) 454-7878
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

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.

What insurance does Mark Wegmann accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana 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 November 14, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.