Dr Peter J Wiebenga, MD is a medicare enrolled "General Practice" physician in Holland, Michigan. His current practice location is
175 S Waverly Rd, Holland, Michigan. You can reach out to his office (for appointments etc.) via phone at
(616) 392-5222.
Dr Peter J Wiebenga is licensed to practice in Michigan (license number 4301032024) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225003825.
Physician's Profile
Full Name | Dr Peter J Wiebenga |
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Gender | Male |
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Speciality | General Practice |
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Location | 175 S Waverly Rd, Holland, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1225003825
- Provider Enumeration Date: 02/17/2006
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 9234298621
- Enrollment ID: I20090106000312
Medical Identifiers
Medical identifiers for Dr Peter J Wiebenga such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225003825 | NPI | - | NPPES |
P32249 | Other | MI | PJW BCN |
4301032024 | Other | MI | PJW STATE |
PW032024 | Other | MI | PJW BCBSMI |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 4301032024 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Peter J Wiebenga allows following entities to bill medicare on his behalf.
Entity Name | American Current Care Of Michigan Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1659562262 PECOS PAC ID: 5799886313 Enrollment ID: O20070726000695 |
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Entity Name | Holland Medical Care & Rehabilitation Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609079508 PECOS PAC ID: 4486712015 Enrollment ID: O20081024000674 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Peter J Wiebenga is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Peter J Wiebenga, MD 175 S Waverly Rd, Holland, MI 49423-7907 Ph: (616) 392-5222 | Dr Peter J Wiebenga, MD 175 S Waverly Rd, Holland, MI 49423-7907 Ph: (616) 392-5222 |
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