Marc W. Weise, M.D., Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2852009 Issued in CA

Legal business name

MARC W. WEISE, M.D., INC.

Practice address

2 James Way
Suite 115
Pismo Beach, CA 93449-4973

Phone

(805) 773-2650

Fax

(805) 773-2655

NPI assigned

Feb 27, 2007

Last updated

May 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marc W Weise, MDNPI 1609843499

Title

President

Phone

(805) 773-2650

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc W. Weise, M.D.

  • Orthopaedic Surgery Physician
  • Pismo Beach, CA
  • NPI 1609843499
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1174650279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 115",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-2650",
            "fax_number": "805-773-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 115",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-2650",
            "fax_number": "805-773-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC W. WEISE, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "WEISE",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-773-2650",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "5684480001",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "2852009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDEPT OF LABOR",
            "identifier": "611373100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas John Maccready, D.C.
• Vincent Thomas Maloney, LMFT
• Megan M Malzone, MD
• Paul Lyle Manosar, PT
• Farah Mansuri, M.D.
• Ruben Marquez
• Barbara Hayek Marsden, L. AC.
• Ann Marie McDonald, NP
• Ann Louise McNeil, NP
• Megan Richert, Licensed Clinical Social Worker, Inc (Bloom Maternal Therapy)

• Orthopaedic Surgery Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.