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MARY ANN WIETBROCK RN MSN ACNS-BC
NPI 1336551175
Clinical Nurse Specialist in Cumberland, IN

Active since May 28, 2014PECOS EnrolledAccepts Medicare Assignment
102 GRANBY DR, CUMBERLAND, IN 46229(317) 410-9140(317) 861-1556 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mary Ann Wietbrock Rn Msn Acns-bc NPPES

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

MARY ANN WIETBROCK RN MSN ACNS-BC (NPI 1336551175) is an individual clinical nurse specialist in Cumberland, Indiana, licensed in Indiana (28088637A) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1336551175
Entity TypeIndividualFemale
Primary Taxonomy364S00000X
Provider Legal NameMARY ANN WIETBROCKCredential: RN MSN ACNS-BC
Location Address102 GRANBY DRCumberland, IN 46229-4203
Mailing Address4108 W 400 SNew Palestine, IN 46163-9612 · (317) 410-9140
Phone(317) 410-9140
Fax(317) 861-1556
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateMay 28, 2014
Last NPPES UpdateOctober 17, 2024
NPPES CertifiedOctober 17, 2024
✔ NPI 1336551175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364S00000X
License✔ Licensed in IN · 28088637A
Definition
A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration.
102 GRANBY DR, Cumberland, IN 46229
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Mary Ann Wietbrock Rn Msn Acns-bc 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 ID7517243165
PECOS Enrollment IDI20170418001404
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 2

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.
152 services18 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
123 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46229 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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 Mary Ann Wietbrock's NPI number?

The NPI number for Mary Ann Wietbrock is 1336551175. It was assigned to this individual provider in the NPPES registry on May 28, 2014.

Where is Mary Ann Wietbrock located?

Mary Ann Wietbrock practices at 102 Granby Dr, Cumberland, IN 46229. The listed phone number is (317) 410-9140.

What is Mary Ann Wietbrock's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist with taxonomy code 364S00000X.

Is Mary Ann Wietbrock enrolled in Medicare?

Yes. Mary Ann Wietbrock 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.

When was this NPI record last updated?

The NPPES record for Mary Ann Wietbrock was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.