Individual provider Active NPI

Marissa A Weaver, PA-C

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1053544387
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054108 Issued in PA
Practice address
2895 Hamilton Blvd
Suite 104
Allentown, PA 18104-6172
Phone
(610) 435-8986
Fax
(610) 435-8307
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054108 PA Primary

Addresses

Primary practice location

2895 Hamilton Blvd
Suite 104
Allentown, PA 18104-6172

Mailing address

2895 Hamilton Blvd
Suite 104
Allentown, PA 18104-6172
Phone (610) 435-8986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091130000202 PA Practitioner - Physician Assistant 2466591771 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Health Urgent Care, LLCGroup PAC ID 2668716069, 57 clinicians

Practice addresses (Care Compare)

1050 E Philadelphia Ave
Gilbertsville, PA 19525-9517
Phone (610) 561-6400

1139 Ben Franklin Hwy W
Suite 114
Douglassville, PA 19518-1853
Phone (610) 385-4444

16 Glocker Way
Pottstown, PA 19465-9655
Phone (484) 659-1500

2101 State Hill Rd
Suite 5
Wyomissing, PA 19610-1993
Phone (610) 898-2490

33 W Ridge Pike
Suite 627
Limerick, PA 19468-1824
Phone (610) 226-6200

4603 Perkiomen Ave
Reading, PA 19606-3217
Phone (484) 750-3895

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.28 of 100Reported as group
Quality
82.46
Promoting interoperability
97
Improvement activities
40
Cost
44.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA054108PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Farhad Sholevar, LLC Past Accepting new patients
Emergency Physicians of Connecticut PC Past Accepting new patients
Doylestown Emergency Associates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mweaver350655@direct-sluhn.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1053544387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2895 HAMILTON BLVD",
            "address_2": "SUITE 104",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046172",
            "telephone_number": "610-435-8986",
            "fax_number": "610-435-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 HAMILTON BLVD",
            "address_2": "SUITE 104",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046172",
            "telephone_number": "610-435-8986",
            "fax_number": "610-435-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "MARISSA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.