Individual provider Active NPI

Stephen Anthony Weller, MD

  • Radiation Oncology Physician
  • Mountain View, CA
National Provider Identifier
1154312890
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C34851 Issued in CA
Practice address
701 E. El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7000
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X C34851 CA Primary

Addresses

Primary practice location

701 E. El Camino Real
Mountain View, CA 94040-2833

Mailing address

2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-6203

Other identifiers 2

IdentifierTypeStateIssuer
00C348510OtherCABLUE SHIELD
00C348510MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C34851CAMDRadiation Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1154312890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E. EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C34851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C348510",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C348510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.