Individual provider Active NPI

Jason Weigner, D.C.

  • Rehabilitation Chiropractor
  • Brookhaven, PA
National Provider Identifier
1063549756
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC008896 Issued in PA
Practice address
3215 Edgmont Ave
Brookhaven, PA 19015-3104
Phone
(610) 876-6180
Fax
(610) 876-6130
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC008896 PA Primary

Addresses

Primary practice location

3215 Edgmont Ave
Brookhaven, PA 19015-3104

Mailing address

3215 Edgmont Ave
Brookhaven, PA 19015-3104
Phone (610) 876-6180

Other identifiers 2

IdentifierTypeStateIssuer
1419443OtherPAHIGHMARK BS OF PA PIN
2105742000OtherPAINDEPENDENCE BC OF PA PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707000722 PA Practitioner - Chiropractic 7315983715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Discover Optimal HealthcareGroup PAC ID 9739334343, 4 clinicians

Practice addresses (Care Compare)

3605 Edgmont Ave
Brookhaven, PA 19015-2862
Phone (610) 876-6180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Discover Optimal Healthcare CurrentSince Jan 10, 2013 Accepting new patients
Advanced Care Centers PC Rehabilitation PastSince Jul 3, 2007 Accepting new patients
Advanced Care Centers of Delaware, Inc. Rehabilitation PastSince Aug 2, 2005 Accepting new patients
Optimal Orthopaedics PLLC Rehabilitation PastSince Jan 1, 2021 Accepting new patients

Locations

3605 Edgmont Ave
Ste A
Brookhaven, PA 19015
Phone (610) 876-6180

3215 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-6180

3605 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-6180

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063549756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 EDGMONT AVE",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190153104",
            "telephone_number": "610-876-6180",
            "fax_number": "610-876-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 EDGMONT AVE",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190153104",
            "telephone_number": "610-876-6180",
            "fax_number": "610-876-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGNER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC008896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS OF PA PIN",
            "identifier": "1419443",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BC OF PA PIN",
            "identifier": "2105742000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.