Active NPI
Mitchell J Weiss, M.D.
- Pediatric Hematology & Oncology Physician
- Memphis, TN
National Provider Identifier
1063428597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- MD070098L
- Practice address
- 262 Danny Thomas PL
Memphis, TN 38105-3678 - Phone
- (901) 595-3006
- Fax
- (901) 595-3842
- NPI assigned
- Aug 1, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD070098L | PA | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | MD070098L | PA | Primary |
Addresses
Primary practice location
262 Danny Thomas PL
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas PL
Memphis, TN 38105-3678
Phone (901) 595-3006
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8218609 | Medicaid | NJ | |
| 001757632 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ophthalmic Partners of Pennsylvania, PC | Past | Accepting new patients |
Interoperability endpoints
- mweiss21632@stjude.direct-ci.com
- mweiss31135@mlh.direct-ci.com
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Bala Cynwyd, PA
- NPI 1912970666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1063428597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "MITCHELL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD070098L",
"primary": false
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "PA",
"license": "MD070098L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8218609",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001757632",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.