Active NPI
Michael S Weiss, MD
- Physical Medicine & Rehabilitation Physician
- Boise, ID
National Provider Identifier
1174574271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- M5147
- Practice address
- 703 Americana Blvd
Boise, ID 83702-6754 - Phone
- (208) 706-7500
- Fax
- (208) 706-7501
- NPI assigned
- May 13, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | M5147 | ID | Primary |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | M5147 | ID |
Addresses
Primary practice location
703 Americana Blvd
Boise, ID 83702-6754
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
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
| License | State | Type | Specialty |
|---|---|---|---|
| M5147 | ID | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boise Radiology Group PLLC | Past | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1740216175
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1174574271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 AMERICANA BLVD",
"city": "BOISE",
"state": "ID",
"postal_code": "837026754",
"telephone_number": "208-706-7500",
"fax_number": "208-706-7501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-13",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "ID",
"license": "M5147",
"primary": true
},
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "ID",
"license": "M5147",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.