Active NPI
Theodore Weiss, M.D.
- Psychiatry Physician
- Wynnewood, PA
National Provider Identifier
1083634257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD014735E
- Practice address
- 100 E Lancaster Ave
116 Lankenau Medical Building South
Wynnewood, PA 19096-3450 - Phone
- (610) 649-7006
- NPI assigned
- Jul 20, 2006
- Last updated
- Oct 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD014735E | PA | Primary |
Addresses
Primary practice location
100 E Lancaster Ave
116 Lankenau Medical Building South
Wynnewood, PA 19096-3450
Mailing address
100 E Lancaster Ave
116 Lankenau Medical Building South
Wynnewood, PA 19096-3450
Phone (610) 649-7006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 736674 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD014735E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507248000000",
"number": "1083634257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"address_2": "116 LANKENAU MEDICAL BUILDING SOUTH",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "610-649-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"address_2": "116 LANKENAU MEDICAL BUILDING SOUTH",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "610-649-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "THEODORE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2017-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD014735E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "736674",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.