Active NPI
Roberta Alice Weiss, M.D.
- Nephrology Physician
- Wynnewood, PA
National Provider Identifier
1124347323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD040115E
- Practice address
- 936 Clover Hill Rd
Wynnewood, PA 19096-1631 - Phone
- (610) 212-3474
- NPI assigned
- May 27, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD040115E | PA | |
| Nephrology Physician | 207RN0300X | MD040115E | PA | Primary |
Addresses
Primary practice location
936 Clover Hill Rd
Wynnewood, PA 19096-1631
Mailing address
936 Clover Hill Rd
Wynnewood, PA 19096-1631
Phone (610) 212-3474
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD040115E | PA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274918400000",
"number": "1124347323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "936 CLOVER HILL RD",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190961631",
"telephone_number": "610-212-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "936 CLOVER HILL RD",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190961631",
"telephone_number": "610-212-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "ROBERTA",
"middle_name": "ALICE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-27",
"last_updated": "2010-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD040115E",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "PA",
"license": "MD040115E",
"primary": true
}
],
"identifiers": [],
"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 May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.