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

Active since August 09, 2005PECOS Enrolled
99.04/100
CMS Quality Rating
3890 CHARLEVOIX RD STE 307, PETOSKEY, MI 49770(231) 674-3834 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 31, 2026, Jun 12, 2018 (2 updates tracked since 2018).

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.

NPPES Registry Identity

NPI1235130576
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCAROLYN MARIE WIESECredential: PA
Location Address3890 CHARLEVOIX RD STE 307Petoskey, MI 49770-9719
Mailing Address743 E Beltline Ave NeGrand Rapids, MI 49525-6045 · (616) 320-0096
Phone(231) 674-3834
Sole ProprietorNo
Enumeration DateAugust 9, 2005
Last NPPES UpdateAugust 31, 20262 updates tracked since enumeration
NPPES CertifiedAugust 31, 2026
✔ 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)
3890 CHARLEVOIX RD STE 307, Petoskey, MI 49770
Open in Google Maps ↗

Other Identifiers 1

Medicaid1235130576MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn Marie Wiese Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

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

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

DR. AMY BODNARCHUK M.D.
Internal Medicine
3890 CHARLEVOIX RD STE 307
PETOSKEY, MI 49770
Emmet County (231) 360-2496

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 3890 Charlevoix Rd Ste 307, Petoskey, MI 49770. The listed phone number is (231) 674-3834.

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 enrollment system.

When was this NPI record last updated?

The NPPES record for Carolyn Wiese was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.