Individual provider Active NPI

Charles W Weldy, DPM

  • Podiatrist
  • Canonsburg, PA
National Provider Identifier
1194704809
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002527L Issued in PA
Practice address
111 S Central Ave
Canonsburg, PA 15317-1551
Phone
(724) 746-1870
Fax
(724) 746-6752
NPI assigned
Jan 11, 2006
Last updated
Feb 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002527L PA Primary

Addresses

Primary practice location

111 S Central Ave
Canonsburg, PA 15317-1551

Mailing address

111 S Central Ave
Canonsburg, PA 15317-1551
Phone (724) 746-1870

Other identifiers 1

IdentifierTypeStateIssuer
0010416250002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000077 PA Practitioner - Podiatry 7719158880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canonsburg Podiatry AssociatesGroup PAC ID 8325086929, 2 clinicians

Practice addresses (Care Compare)

111 S Central Ave
Canonsburg, PA 15317-1551
Phone (724) 746-1870

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC002527LPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Canonsburg Podiatry Associates Podiatrist CurrentSince Aug 5, 1982 Accepting new patients

Locations

111 S Central Ave
Canonsburg, PA 15317
Phone (412) 746-1870

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.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1194704809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S CENTRAL AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171551",
            "telephone_number": "724-746-1870",
            "fax_number": "724-746-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S CENTRAL AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171551",
            "telephone_number": "724-746-1870",
            "fax_number": "724-746-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDY",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002527L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010416250002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.