MR. DOMINIK WIEST (PA-C) – Physician Assistant, NPI 1215563267
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for MR. DOMINIK WIEST (PA-C)
1105 Sixth St
Traverse City, MI 496842345
Phone: (231) 779-0320
Fax: (231) 779-1367
Type: Location
9000 WAUKEGAN RD STE 200900
MORTON GROVE, IL 600532127
Phone:
Type: Mailing
9000 WAUKEGAN RD STE 200
MORTON GROVE, IL 600532127
Phone: (847) 375-3000
Type: Location
3537 W Front St Ste E
Traverse City, MI 496847943
Phone: (231) 935-5880
Type: Location
7665 S US 131 Hwy
Cadillac, MI 49601
Phone: (231) 876-7526
Type: Location
9000 Waukegan Rd Ste 200
Morton Grove, IL 600532127
Phone: (847) 375-3000
Type: Location
8872 Professional Dr Ste B
Cadillac, MI 496018482
Phone: (231) 779-0320
Fax: (231) 779-1367
Type: Location
400 HOBART ST
CADILLAC, MI 496012331
Phone: (231) 876-7200
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $428.
Total Amount is formed as General ($428) + Research ($0) + Ownership ($0) = $428.
Last reported payment date: 2024-07-31 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($415).
Total Amount
$428
General + Research + Ownership
Payments
7
Total payment records
General Amount
$428
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $415 |
| Lightbody Medical Technologies Inc | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-07-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210729002813 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 47 | 44 | $0 |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 20 | 20 | $0 |
Insurance plans in this area (ZIP 49684)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Nurse Practitioner | MI | |
| A N E S T H E S I O L O G Y | IL | |
| Nurse Practitioner | MI | |
| - | MI | |
| - | NC | |
| - | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH |
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