Jake Anthony Weisberg, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Phone

(503) 701-4624

NPI assigned

Mar 19, 2022

Last updated

Feb 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  OR

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1053060988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 COPLEY ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632670",
            "telephone_number": "805-404-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-701-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19555 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853086813",
            "country_code": "US",
            "telephone_number": "623-572-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 W 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042307",
            "country_code": "US",
            "telephone_number": "509-474-3020",
            "fax_number": "509-474-5316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISBERG",
        "first_name": "JAKE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-19",
        "last_updated": "2025-02-01",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "DO222057",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moses Milo Weir
• Nikole E Weir
• Karen Lavery Weis, D.O.
• Kathleen Muldoon Weis, MD, MPH
• Nicole Weis, PA-C
• Stuart Gordon Weisberg, M.D.
• Katharine Weisbrodt
• Deborah Weise
• Maggi Weiseman, ND
• James Patrick Weisgerber, PT

• Student in an Organized Health Care Education/Training Program in Portland, OR
• Providers in Portland, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.

Verify at the official NPI Registry.