Active NPI
Mark Aaron Weiner, D.O.
- Family Medicine Physician
- Toledo, OH
National Provider Identifier
1114901253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34005502
- Practice address
- 3120 Glendale Ave
Family Medicine Suite
Toledo, OH 43614-5811 - Phone
- (419) 383-5555
- Fax
- (419) 383-3113
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34005502 | OH | Primary |
Addresses
Primary practice location
3120 Glendale Ave
Family Medicine Suite
Toledo, OH 43614-5811
Mailing address
3355 Glendale Ave
Third Floor
Toledo, OH 43614-2426
Phone (419) 383-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0883889 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070509000780 | OH | Practitioner - Family Practice | 7618073594 |
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.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34005502 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health - St Vincent Medical Center LLC | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| University of Toledo Physicians LLC | Past | Accepting new patients | |
| Noes/Paulding, LTD | Past | Accepting new patients | |
| Northwest Ohio Emergency Services, Inc. | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1467493551
-
- Emergency Medicine Physician
- Sylvania, OH
- NPI 1619997459
-
- Emergency Medicine Physician
- Toledo, OH
- NPI 1407992902
-
- Internal Medicine Physician
- Toledo, OH
- NPI 1942296033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1114901253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 GLENDALE AVE",
"address_2": "THIRD FLOOR",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436142426",
"telephone_number": "419-383-7100",
"fax_number": "419-383-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3120 GLENDALE AVE",
"address_2": "FAMILY MEDICINE SUITE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436145811",
"telephone_number": "419-383-5555",
"fax_number": "419-383-3113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINER",
"first_name": "MARK",
"middle_name": "AARON",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34005502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0883889",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.