NPIMap

Individual provider Active NPI

Donald L Weese Jr., MD

  • Urology Physician
  • Burley, ID
National Provider Identifier
1154323392
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-6230 Issued in ID
Practice address
1501 Hiland Ave Ste H
Burley, ID 83318-2688
Phone
(208) 677-6266
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 33863 OK
Urology Physician 208800000X M-6230 ID Primary

Addresses

Primary practice location

1501 Hiland Ave Ste H
Burley, ID 83318-2688

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice location 1

205 S Park Ln
Altus, OK 73521-5755
Phone (580) 379-6480

Other identifiers 1

IdentifierTypeStateIssuer
200785630BMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DonaldWeese@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20070619000699 ID Practitioner - Urology 4587763370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Baylor College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

1501 Hiland Ave
Burley, ID 83318-2688
Phone (208) 678-4444

Hospital & facility affiliations

  • Cassia Regional Hospital Hospital, Burley, ID, CCN 131326
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Minidoka Memorial Hospital Hospital, Rupert, ID, CCN 131319

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-6230IDMDUrology Physician
33863OKMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Nov 20, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 20, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

1501 Hiland Ave
Ste H
Burley, ID 83318
Phone (208) 677-6082

Interoperability endpoints

  • Direct secure messaging: donaldweese@direct.jcmh.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1154323392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE STE H",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182688",
            "telephone_number": "208-677-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S Park Ln",
            "address_purpose": "LOCATION",
            "city": "Altus",
            "state": "OK",
            "postal_code": "735215755",
            "country_code": "US",
            "telephone_number": "580-379-6480",
            "fax_number": "580-379-6489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEESE",
        "first_name": "DONALD",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "33863",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M-6230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200785630B",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DonaldWeese@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "205 S Park Ln",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

Verify at the official NPI Registry.