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MARK D WIEDERHOLD M.D.
NPI 1598015745
Internal Medicine in San Diego, CA

Active since September 14, 2012PECOS Enrolled
9565 WAPLES ST, SUITE 200, SAN DIEGO, CA 92121(858) 642-0267(858) 642-0285 Get Directions Write a Review

NPPES record last updated: September 14, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mark D Wiederhold M.d. NPPES

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

MARK D WIEDERHOLD M.D. (NPI 1598015745) is an individual internal medicine provider in San Diego, California, licensed in California (G66151) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1598015745
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMARK D WIEDERHOLDCredential: M.D.
Location Address9565 WAPLES ST, SUITE 200San Diego, CA 92121-2986
Mailing Address9565 Waples St, Suite 200San Diego, CA 92121-2986 · (858) 642-0267 · Fax (858) 642-0285
Phone(858) 642-0267
Fax(858) 642-0285
Sole ProprietorYes
Enumeration DateSeptember 14, 2012
✔ NPI 1598015745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G66151
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
9565 WAPLES ST, San Diego, CA 92121
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark D Wiederhold M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Mark Wiederhold reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mission Valley Medical Infusion Center, PC
9.3 mi
Internal Medicine
3530 CAMINO DEL RIO N STE 200
San Diego, CA 92108
  • Reassigned Medicare billing, California enrollment
  • 2 clinicians in this Medicare group
NPI 1871439711 (619) 992-9778

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92121 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
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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 Mark Wiederhold's NPI number?

The NPI number for Mark Wiederhold is 1598015745. It was assigned to this individual provider in the NPPES registry on September 14, 2012.

Where is Mark Wiederhold located?

Mark Wiederhold practices at 9565 Waples St Suite 200, San Diego, CA 92121. The listed phone number is (858) 642-0267.

What is Mark Wiederhold's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mark Wiederhold enrolled in Medicare?

Yes. Mark Wiederhold is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mark Wiederhold's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Wiederhold reassigns Medicare benefits to Mission Valley Medical Infusion Center, PC (San Diego, CA). The 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 Wiederhold's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mark Wiederhold was last updated on September 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.