NPIMap

Individual provider Active NPI

Cristin A Weicker, D.O.

  • Internal Medicine Physician
  • Pottsville, PA
National Provider Identifier
1114910320
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS013220 Issued in PA
Practice address
205 E Laurel Blvd
Pottsville, PA 17901-2534
Phone
(570) 622-1887
Fax
(570) 622-1959
NPI assigned
Aug 24, 2005
Last updated
Feb 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS013220 PA Primary

Addresses

Primary practice location

205 E Laurel Blvd
Pottsville, PA 17901-2534

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 2

IdentifierTypeStateIssuer
1013949780001MedicaidPA
P00232917OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000365 PA Practitioner - Internal Medicine 6709815327 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

700 E Norwegian St
Pottsville, PA 17901-2710
Phone (570) 621-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS013220PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Sep 15, 2014 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Integrated Medical Group P C Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Sep 15, 2014 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Apr 1, 2017 Accepting new patients
Lehigh Valley Hospital - Schuylkill Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

121 N Tulpehocken St
Pine Grove, PA 17963
Phone (570) 345-2345

106 S Claude a Lord Blvd
Pottsville, PA 17901
Phone (570) 622-4209

205 E Laurel Blvd
Pottsville, PA 17901
Phone (570) 622-1887

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488067200000",
    "number": "1114910320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E LAUREL BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012534",
            "telephone_number": "570-622-1887",
            "fax_number": "570-622-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEICKER",
        "first_name": "CRISTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2017-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS013220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013949780001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00232917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.