Active NPI
Robert Weitzman, MD
- Ophthalmology Physician
- Gaithersburg, MD
National Provider Identifier
1164640934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- D54360
- Practice address
- 754 Summerwalk Drive
Gaithersburg, MD 20878 - Phone
- (301) 330-0917
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | D54360 | MD | Primary |
Addresses
Primary practice location
754 Summerwalk Drive
Gaithersburg, MD 20878
Mailing address
PO Box 3507
Gaithersburg, MD 20885-3507
Phone (301) 330-0917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140709000909 | MD | Order and Referring Only - Internal Medicine | 5597980466 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D54360 | MD | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164640934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3507",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208853507",
"telephone_number": "301-330-0917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "754 SUMMERWALK DRIVE",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20878",
"telephone_number": "301-330-0917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEITZMAN",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MD",
"license": "D54360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.