Mark Leroy Vanderweide, CRNA in Charlevoix, MI - Medicare Nurse Anesthetist, Certified Registered

Mark Leroy Vanderweide, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Charlevoix, Michigan. His current practice location is 14700 Lake Shore Dr, Charlevoix, Michigan. You can reach out to his office (for appointments etc.) via phone at (231) 547-4024.

Mark Leroy Vanderweide is licensed to practice in Michigan (license number 4704293836) 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 1225758824.

Contact Information

	Mark Leroy Vanderweide, CRNA
	14700 Lake Shore Dr, Charlevoix, MI 49720-1999
	(231) 547-4024
	Not Available

Map and Direction

Provider's Profile

Full Name	Mark Leroy Vanderweide
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	14700 Lake Shore Dr, Charlevoix, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225758824
Provider Enumeration Date: 09/01/2022
Last Update Date: 10/12/2022

Medicare PECOS Information:

PECOS PAC ID: 0941673115
Enrollment ID: I20230309000351

Medical Identifiers

Medical identifiers for Mark Leroy Vanderweide such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225758824	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	4704293836 (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. Mark Leroy Vanderweide allows following entities to bill medicare on his behalf.

Entity Name	Munson Healthcare Charlevoix Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326124058 PECOS PAC ID: 4284528035 Enrollment ID: O20040211001170

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. Mark Leroy Vanderweide 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
Mark Leroy Vanderweide, CRNA 854 Dorroll St Ne, Grand Rapids, MI 49505-4209 Ph: (616) 914-6532	Mark Leroy Vanderweide, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1999 Ph: (231) 547-4024

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Charlevoix, MI

Michael C Macmillan, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12375 Indian Place Dr, Charlevoix, MI 49720 Phone: 231-547-2496 Fax: 231-547-2823
Michael Johnson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088
Jennifer L Simons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024
Mel Choponis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088
Kenneth Forrester, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088
Madeline Jeakle Nemes, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024

Mark Leroy Vanderweide, CRNA - Medicare Nurse Anesthetist, Certified Registered in Charlevoix, MI