NPIMap

Individual provider Active NPI

Douglas Keith Weitzman, M.D.

  • Family Medicine Physician
  • Carrollton, VA
National Provider Identifier
1174507164
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101040484 Issued in VA
Practice address
20209 Sentara Way Ste 200
Carrollton, VA 23314-3574
Phone
(757) 542-2000
Fax
(757) 542-2001
NPI assigned
Dec 2, 2005
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101040484 VA Primary

Addresses

Primary practice location

20209 Sentara Way Ste 200
Carrollton, VA 23314-3574

Mailing address

20209 Sentara Way Ste 200
Carrollton, VA 23314-3574
Phone (757) 542-2000

Other practice location 1

919 S Church St
Smithfield, VA 23430-1715
Phone (757) 365-8031

Other identifiers 3

IdentifierTypeStateIssuer
381159OtherVAANTHEM PROVIDER NUMBER
41040OtherVAOPTIMA HEALTH PROVIDER NO
7300743MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070123000177 VA Practitioner - Family Practice 8527069368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

20209 Sentara Way
Suite 200
Carrollton, VA 23314-3573
Phone (757) 542-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Family Medicine CurrentSince Oct 1, 2006 Accepting new patients

Locations

20209 Sentara Way
Ste 200
Carrollton, VA 23314
Phone (757) 542-2000

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

919 S Church St
Smithfield, VA 23430
Phone (757) 357-3291

Interoperability endpoints

  • Direct secure messaging: dweitzman9954@direct.sentara.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1174507164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20209 SENTARA WAY STE 200",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233143574",
            "telephone_number": "757-542-2000",
            "fax_number": "757-542-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20209 SENTARA WAY STE 200",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233143574",
            "telephone_number": "757-542-2000",
            "fax_number": "757-542-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 S Church St",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "VA",
            "postal_code": "234301715",
            "country_code": "US",
            "telephone_number": "757-365-8031",
            "fax_number": "757-356-9451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEITZMAN",
        "first_name": "DOUGLAS",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101040484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "381159",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PROVIDER NO",
            "identifier": "41040",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7300743",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, VA

Sources for this page

Verify at the official NPI Registry.