Active NPI
Derek Edward Weiss, PA-C
- Physician Assistant
- Camp Lejeune, NC
National Provider Identifier
1083147060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- Naval Medical Center
100 Brewster Blvd
Camp Lejeune, NC 28547 - Phone
- (910) 450-4740
- NPI assigned
- Apr 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
Naval Medical Center
100 Brewster Blvd
Camp Lejeune, NC 28547
Mailing address
313 Hickory KNL
Hubert, NC 28539-4391
Phone (443) 603-3694
Other practice location 1
Naval Medical Center San Diego
34800 Bob Wilson Drive
San Diego, CA 92134-0001
Phone (443) 603-3694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Associates P.a., P.C. | Current | Accepting new patients |
Locations
15001 Health Center Dr
Bowie, MD 20716
Phone (301) 262-5511
1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000
Interoperability endpoints
- dweiss848922@direct.umm.edu
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Falls Church, VA
- NPI 1134117393
DC
-
- Internal Medicine Physician
- Culpeper, VA
- NPI 1881559102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1083147060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 HICKORY KNL",
"city": "HUBERT",
"state": "NC",
"postal_code": "285394391",
"telephone_number": "443-603-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL MEDICAL CENTER",
"address_2": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "28547",
"telephone_number": "910-450-4740"
}
],
"practiceLocations": [
{
"address_1": "Naval Medical Center San Diego",
"address_2": "34800 Bob Wilson Drive",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921340001",
"country_code": "US",
"telephone_number": "443-603-3694",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEISS",
"first_name": "DEREK",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-06",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.