Active NPI
Maurice Weise, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1043417264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G28604
- Practice address
- 12021 Wilmington Ave
Los Angeles, CA 90059-3019 - Phone
- (323) 242-5000
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G28604 | CA | Primary |
Addresses
Primary practice location
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Mailing address
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Phone (323) 242-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of State Hospitals | Current | Accepting new patients | |
| Department of State Hospitals | Current | Accepting new patients | |
| Shields for Families | Current | Accepting new patients | |
| Department of State Hospitals | Current | Accepting new patients | |
| Los Angeles County Department of Public Health | Current | Accepting new patients | |
| Amanecer Community Counseling Service, a Non-Profit Corporation | Past | Accepting new patients |
Locations
11601 S Western Ave
Los Angeles, CA 90047
Phone (800) 676-9870
3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000
1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805
Interoperability endpoints
- mauriceweise-shieldsforfamilies@lacsapc.netsmartdirect.net
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Coalinga, CA
- NPI 1124078704
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1659506145
-
- Psychiatric Hospital
- Patton, CA
- NPI 1043249204
-
- Psychiatric Hospital
- Atascadero, CA
- NPI 1174573802
-
- Public Health or Welfare Agency
- Alhambra, CA
- NPI 1700090834
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1053449900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1043417264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12021 WILMINGTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900593019",
"telephone_number": "323-242-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12021 WILMINGTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900593019",
"telephone_number": "323-242-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISE",
"first_name": "MAURICE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-29",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G28604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.