Individual provider Active NPI

Michael S Weiss, MD

  • Physical Medicine & Rehabilitation Physician
  • Boise, ID
National Provider Identifier
1174574271
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M5147 Issued in ID
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

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
M5147IDMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.