NPIMap

Individual provider Active NPI

Nicholas Keith Weber, MD

  • Gastroenterology Physician
  • Olympia, WA
National Provider Identifier
1164544953
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD60445962 Issued in WA
Practice address
209 Lilly Rd NE
Olympia, WA 98506-5030
Phone
(360) 413-8250
Fax
(360) 413-8830
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60445962 WA
Gastroenterology Physician 207RG0100X MD60445962 WA Primary

Addresses

Primary practice location

209 Lilly Rd NE
Olympia, WA 98506-5030

Mailing address

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

Other practice location 1

500 Lilly Rd NE Ste 204
Olympia, WA 98506-5197
Phone (360) 413-8250

Other identifiers 1

IdentifierTypeStateIssuer
326227OtherWASTATE L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140731002857 WA Practitioner - GastroenterologyPractitioner - Internal Medicine 8921286964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Kentucky College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Gastroenterology PLLCGroup PAC ID 1759278252, 59 clinicians

Practice addresses (Care Compare)

11800 NE 128TH St
Suite 100
Kirkland, WA 98034-7208
Phone (425) 899-4500

13020 Meridian Ave S
Everett, WA 98208-6468
Phone (425) 977-4620

16504 9TH Ave SE
Suite 106
Mill Creek, WA 98012-6388
Phone (425) 977-4626

209 Lilly Rd NE
Suite B
Olympia, WA 98506-5030
Phone (360) 413-8250

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy115
Upper gastrointestinal (GI) endoscopy for acid reflux173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60445962WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates Clinical Practice, PLLC Gastroenterology CurrentSince Oct 1, 2019 Accepting new patients
Puget Sound Gastroenterology, PLLC Current Accepting new patients
Puget Sound Gastroenterology, PLLC Gastroenterology CurrentSince Jan 1, 2023 Accepting new patients
Puget Sound Gastroenterology, PLLC Gastroenterology Current Accepting new patients
Puget Sound Gastroenterology, PLLC Gastroenterology CurrentSince Jan 1, 2023 Accepting new patients
Lake Washington Anesthesia PLLC Past Accepting new patients
Cellnetix Pathology, PLLC Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Puget Sound Gastroenterology, PLLC Past Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

16504 9th Ave SE
Ste 201
Mill Creek, WA 98012
Phone (425) 686-7138

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

209 Lilly Rd NE
Ste B
Olympia, WA 98506
Phone (360) 413-8250

500 Lilly Rd NE
Ste 204
Olympia, WA 98506
Phone (360) 413-8191

Interoperability endpoints

  • FHIR API: https://7e6d65ac-543a-4d66-acb8-36b51c8c951c.gastro.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: nicholas.weber@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 9

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 8

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1164544953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065030",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lilly Rd NE Ste 204",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065197",
            "country_code": "US",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBER",
        "first_name": "NICHOLAS",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60445962",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60445962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "326227",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.