Active NPI
Michael Dale Weil, PSY.D.
- Clinical Psychologist
- Peterborough, NH
National Provider Identifier
1104932227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 468
- Practice address
- 20 Grove St
Peterborough, NH 03458-1470 - Phone
- (603) 924-7462
- Fax
- (603) 924-2138
- NPI assigned
- Aug 22, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 468 | NH | Primary |
Addresses
Primary practice location
20 Grove St
Peterborough, NH 03458-1470
Mailing address
20 Grove St
Peterborough, NH 03458-1470
Phone (603) 924-7462
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1002835 | Other | NH | CIGNA |
| NH 468 | Other | NH | HEALTH CARE VALUE MANAGEM |
| 30002642 | Medicaid | NH | |
| 015523 | Other | HARVARD PILGRIM HEALTH | |
| 0606182Y0NH01 | Other | NH | ANTHEM BLUE CROSS |
| NH 468 | Other | NH | CBA |
| NH 468 | Other | NH | AETNA |
| NH 468 | Other | NH | UNITED BEHAVIORAL HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 468 | NH | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centers for Pain Solutions,LLC | Past | Accepting new patients | |
| Pain Solutions PLLC | Past | Accepting new patients |
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.
-
- Ambulatory Surgical Clinic/Center
- Nashua, NH
- NPI 1508934373
-
- Pain Medicine Physician
- Nashua, NH
- NPI 1811025877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104932227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 GROVE ST",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581470",
"telephone_number": "603-924-7462",
"fax_number": "603-924-2138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 GROVE ST",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581470",
"telephone_number": "603-924-7462",
"fax_number": "603-924-2138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIL",
"first_name": "MICHAEL",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NH",
"license": "468",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1002835",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH CARE VALUE MANAGEM",
"identifier": "NH 468",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30002642",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH",
"identifier": "015523",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "0606182Y0NH01",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CBA",
"identifier": "NH 468",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "NH 468",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "NH 468",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peterborough, NH
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.