LAWRENCE D WEIDELL (PA-C) – Medical Physician Assistant, NPI 1770540122

LAWRENCE D WEIDELL (PA-C) is a healthcare provider. based in Springfield, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA217838 (OR). The NPI Number for LAWRENCE D WEIDELL (PA-C) is 1770540122

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
LAWRENCE D WEIDELL (PA-C)
NPI
1770540122
Phone
(541) 344-4168
Address
860 BELTLINE RD
Enumeration Date
28 April 2006
Last Update Date
14 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5413444168
Graduation Year
2001 (25 years ago)
PAC ID
1850389339
Group Practice PAC ID
5698218071
Professional Enrollment ID
I20230913000869
Address ID
OR974771091SP860XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:20State licenses:1Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

Provider Addresses for LAWRENCE D WEIDELL (PA-C)

  • 860 BELTLINE RD

    SPRINGFIELD, OR 974771091

    Phone: (541) 344-4168

    Fax: (458) 201-8510

    Type: Location

  • 12469, Emerald Coast Parkway West, Miramar Beach, Walton County, Florida, 32550, United States

    MIRAMAR BEACH, FL 325508305

    Phone: (850) 654-3376

    Fax: (850) 654-3320

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $378.

Total Amount is formed as General ($378) + Research ($0) + Ownership ($0) = $378.

Last reported payment date: 2024-07-30 • Largest payer in this snapshot: Janssen Biotech, Inc. ($171).

Total Amount

$378

General + Research + Ownership

Payments

15

Total payment records

General Amount

$378

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-30

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-09-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110517000503IPhysician AssistantFLTBD
I20230913000869IPhysician AssistantORTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths961192$0
99213Established patient office or other outpatient visit, 20-29 minutes309276$0
17000Destruction of precancer skin growth, 1 growth268236$0
11102Biopsy of related skin growth, first growth156150$0
17110Destruction of skin growth, 1-14 growths112102$0
View full utilization report →

Insurance plans in this area (ZIP 97477)

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Provider's Procedures

LAWRENCE D WEIDELL (PA-C) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTFL17003Destruction of 2-14 skin growths2019306

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698218071View full group profile
NameSpecialtyState
Dermatology, PathologyOR
Micrographic Dermatologic Surgery (Mds), DermatologyOR
Physician AssistantOR

Reviews

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Frequently asked questions

Can I verify LAWRENCE D WEIDELL (PA-C) with an NPI only?
You can start verification with NPI 1770540122 for LAWRENCE D WEIDELL (PA-C), then check state licensing separately.
Can I rely on LAWRENCE D WEIDELL (PA-C) being an active provider?
As of the registry snapshot, LAWRENCE D WEIDELL (PA-C) is marked active.
What is LAWRENCE D WEIDELL (PA-C) best known for clinically?
Directory data describes LAWRENCE D WEIDELL (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does LAWRENCE D WEIDELL (PA-C) serve?
LAWRENCE D WEIDELL (PA-C)'s listing highlights Springfield, Oregon; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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