NPIMap

Individual provider Active NPI

Chad H Weaver, M.D.

  • Dermatology Physician
  • Albert Lea, MN
National Provider Identifier
1235367202
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
53511 Issued in MN
Practice address
404 W Fountain St
Albert Lea, MN 56007
Phone
(507) 373-2384
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 53511 MN Primary

Addresses

Primary practice location

404 W Fountain St
Albert Lea, MN 56007

Mailing address

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Other practice location 1

2603 39th Ave NE
Suite D-202
Minneapolis, MN 55421-4372
Phone (612) 213-2370

Other practice location 2

2603 39th Ave NE
Suite D-202
Minneapolis, MN 55421-4372
Phone (612) 213-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20101216000554 MN Practitioner - Dermatology 3375731433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Winona Health ServicesGroup PAC ID 8527977420, 160 clinicians

Practice addresses (Care Compare)

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650

Hospital & facility affiliations

  • Winona Health Services Hospital, Winona, MN, CCN 240044
  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision86
Removal of skin lesions848
Removal or shaving of skin growth244
Skin biopsy19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105095MNMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Winona Health Services CurrentSince Jan 1, 2023 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jul 21, 2012 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Oct 1, 2015 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Oct 1, 2015 Accepting new patients
Winona Health Services Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1235367202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "56007",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2603 39th Ave NE",
            "address_2": "Suite D-202",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554214372",
            "country_code": "US",
            "telephone_number": "612-213-2370",
            "fax_number": "612-213-2370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2603 39th Ave NE",
            "address_2": "Suite D-202",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554214372",
            "country_code": "US",
            "telephone_number": "612-213-2370",
            "fax_number": "612-213-2370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "CHAD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "53511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.