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CAROLYN MARIE WIESE PA
NPI 1235130576
Physician Assistant in Petoskey, MI

Active since August 09, 2005PECOS EnrolledAccepts Medicare Assignment
99.04/100
CMS Quality Rating
2390 MITCHELL PARK DR STE D, PETOSKEY, MI 49770(231) 487-7200(231) 487-7188 Get Directions Write a Review

NPPES record last updated: June 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carolyn Marie Wiese Pa NPPES

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

CAROLYN MARIE WIESE PA (NPI 1235130576) is an individual physician assistant in Petoskey, Michigan, licensed in Michigan (5601003704) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Mclaren Central Michigan, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1235130576
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCAROLYN MARIE WIESECredential: PA
Location Address2390 MITCHELL PARK DR STE DPetoskey, MI 49770
Mailing Address2390 Mitchell Park Dr Ste DPetoskey, MI 49770-8965 · (231) 487-7200 · Fax (231) 487-7188
Phone(231) 487-7200
Fax(231) 487-7188
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateAugust 9, 2005
Last NPPES UpdateJune 12, 2018
✔ NPI 1235130576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601003704
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA001143 (ME)
2390 MITCHELL PARK DR STE D, Petoskey, MI 49770
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Other Identifiers 1

Medicaid1235130576MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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

Carolyn Marie Wiese Pa 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 ID7416999628
PECOS Enrollment IDI20050527000355
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 7

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 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.
159 services116 patients
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.
56 services40 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
22 services22 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
22 services22 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
20 services20 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Mclaren Central Michigan

Acute Care Hospitals · Mount Pleasant, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230080
Location1221 South DriveMount Pleasant, MI 48858 · Isabella County
Emergency services Birthing friendly

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230105
Location416 Connable AvePetoskey, MI 49770 · Emmet County
Emergency services Birthing friendly

Munson Healthcare Otsego Memorial Hospital

Acute Care Hospitals · Gaylord, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230133
Location825 N Center AveGaylord, MI 49735 · Otsego County
Birthing friendly

Charlevoix Area Hospital

Critical Access Hospitals · Charlevoix, MI
OwnershipVoluntary non-profit - Other
CMS Certification Number231322
Location14700 Lakeshore DriveCharlevoix, MI 49720 · Charlevoix County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49770 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

99.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality83.87
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606
DME-Drugs Administered Through DME · category DG006N
1 supplier14 claims840 services$6.38 avg. paid by Medicare
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677
DME-Drugs Administered Through DME · category DG006N
1 supplier14 claims73,500 services$0.15 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
1 supplier14 claims14 services$26.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

DANIEL VERBURG MD PLC
Obstetrics & Gynecology (Gynecology)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 487-9355
LANCE EDGERTON FNP-C
Nurse Practitioner (Family)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 487-7200
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Pharmacy (Community/Retail Pharmacy)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 242-1760
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Clinic/Center (Federally Qualified Health Center (FQHC))
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 242-1760

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 Carolyn Wiese's NPI number?

The NPI number for Carolyn Wiese is 1235130576. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Where is Carolyn Wiese located?

Carolyn Wiese practices at 2390 Mitchell Park Dr Ste D, Petoskey, MI 49770. The listed phone number is (231) 487-7200.

What is Carolyn Wiese's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Carolyn Wiese enrolled in Medicare?

Yes. Carolyn Wiese 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 Carolyn Wiese accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Carolyn Wiese 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 Carolyn Wiese affiliated with any hospitals?

According to CMS data, Carolyn Wiese is affiliated with Mclaren Central Michigan, Mclaren Northern Michigan, Munson Healthcare Otsego Memorial Hospital and Charlevoix Area Hospital.

When was this NPI record last updated?

The NPPES record for Carolyn Wiese was last updated on June 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.