Individual provider Active NPI

Brent Robert Weed, M.D.

  • Dermatology Physician
  • Fresno, CA
National Provider Identifier
1104804038
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C208136 Issued in CA
Practice address
6730 N West Ave
Fresno, CA 93711-4301
Phone
(559) 439-3000
Fax
(559) 439-3004
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X C208136 CA
Dermatology Physician 207N00000X 51390-020 WI
Dermatopathology Physician 207ND0900X 51390-020 WI
Dermatology Physician 207N00000X C208136 CA Primary
Dermatology Physician 207N00000X 47142 MN
Dermatopathology (Pathology) Physician 207ZD0900X 51390-20 WI

Addresses

Primary practice location

6730 N West Ave
Fresno, CA 93711-4301

Mailing address

6730 N West Ave
Fresno, CA 93711-4301
Phone (559) 439-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bweed@boswell.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000547 WI Practitioner - Dermatology 0648259747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Nevada School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

801 York St
Manitowoc, WI 54220-4630
Phone (920) 683-5278

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions98
Removal or shaving of skin growth1-10
Skin biopsy63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51390-020WIMDDermatopathology Physician
51390-20WIMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Aug 17, 2011 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Aug 17, 2011 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

3935 N Lightning Dr
Appleton, WI 54913
Phone (920) 968-1790

1400 Scheuring Rd
De Pere, WI 54115
Phone (920) 964-0229

1515 Randolph Ct
Manitowoc, WI 54220
Phone (920) 683-3278

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

510 N 17th Ave
Ste C
Wausau, WI 54401
Phone (715) 849-5333

Interoperability endpoints

  • Direct secure messaging: brent.weed@forefrontdermatology.emadirect.md

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1104804038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6730 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937114301",
            "telephone_number": "559-439-3000",
            "fax_number": "559-439-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6730 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937114301",
            "telephone_number": "559-439-3000",
            "fax_number": "559-439-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEED",
        "first_name": "BRENT",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "C208136",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "51390-020",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WI",
            "license": "51390-020",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C208136",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "47142",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "WI",
            "license": "51390-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bweed@boswell.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "EMA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Modernizing Medicine",
            "address_1": "6730 N West Ave",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937114301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.