Individual provider Active NPI

Justin F Weiss, MD

  • Diagnostic Radiology Physician
  • Bonsall, CA
National Provider Identifier
1053387928
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9418 Issued in AZ
Practice address
6052 Villa Santini
Bonsall, CA 92003-6225
Phone
(520) 247-1547
Fax
(866) 433-1610
NPI assigned
Feb 28, 2006
Last updated
Apr 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9418 AZ Primary

Addresses

Primary practice location

6052 Villa Santini
Bonsall, CA 92003-6225

Mailing address

6052 Villa Santini
Bonsall, CA 92003-6225
Phone (520) 247-1547

Other identifiers 1

IdentifierTypeStateIssuer
222068MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, PA, NY, TN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050211000920 AZ Practitioner - Diagnostic Radiology 8628020112 Reassigns benefits to 1 organization
I20081002000491 PA Practitioner - Diagnostic Radiology 8628020112 Practice locations: Ambler, PA
I20090618000380 NY Practitioner - Diagnostic Radiology 8628020112 Reassigns benefits to 2 organizations
I20140207000862 TN Practitioner - Diagnostic Radiology 8628020112 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9418AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Mobile X-Ray, Inc CurrentSince Jan 5, 2018 Accepting new patients
Smith Radiology Inc Diagnostic Radiology Current Accepting new patients
Allied Mobile Imaging, LLC CurrentSince Apr 20, 2021 Accepting new patients
Radiographics, Inc. CurrentSince Jan 1, 2013 Accepting new patients
Mobile Images Acquisition, LLC CurrentSince Jul 14, 2025 Accepting new patients
Distinguished Diagnostic Imaging P.C. CurrentSince Mar 1, 2020 Accepting new patients
Pmdtc, LLC CurrentSince Jul 1, 2017 Accepting new patients
Physician's Mobile X-Ray, Inc CurrentSince Jan 15, 2018 Accepting new patients
Pmdtc, LLC CurrentSince Apr 1, 2022 Accepting new patients
Third Avenue Imaging LLC CurrentSince Mar 1, 2020 Accepting new patients
First Choice Mobile Radiology Service LLC CurrentSince May 1, 2019 Accepting new patients
Radiographics, Inc CurrentSince Jan 1, 2013 Accepting new patients
Ams Mobile Health Diagnostics CurrentSince Oct 5, 2017 Accepting new patients
S S B Diagnostic Imaging Group Inc Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Alpha Diagnostics LLC Past Accepting new patients
Med 97 LLC Past Accepting new patients
Stat Portable X-Ray,Inc. PastSince Jun 10, 2015 Accepting new patients
Diagnostic X-Ray Service, Inc. Past Accepting new patients
Agnews Community Clinic PastSince Apr 1, 2013 Accepting new patients
Alpha Diagnostics LLC Diagnostic Radiology Past Accepting new patients
Mobile X-Ray Services of Shreveport Bossier Inc Past Accepting new patients

Locations

1484 Williamsbridge Rd
Bronx, NY 10461
Phone (718) 828-6800

2781 3rd Ave
Bronx, NY 10455
Phone (718) 402-0300

945 E Park Dr
Ste 102
Harrisburg, PA 17111
Phone (800) 420-9729

2135 Hillshire Cir
Memphis, TN 38133
Phone (901) 382-4175

Organizations & group practices 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1053387928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6052 VILLA SANTINI",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920036225",
            "telephone_number": "520-247-1547",
            "fax_number": "866-433-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6052 VILLA SANTINI",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920036225",
            "telephone_number": "520-247-1547",
            "fax_number": "866-433-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JUSTIN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "9418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222068",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonsall, CA

Sources for this page

Verify at the official NPI Registry.