Individual provider Active NPI

Jeffrey Allen Weaver, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1265497945
Registry record updated Nov 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4645 Issued in TX
Practice address
13218 Trentwood
San Antonio, TX 78231-2256
Phone
(210) 464-3982
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M4645 TX Primary

Addresses

Primary practice location

13218 Trentwood
San Antonio, TX 78231-2256

Mailing address

13218 Trentwood
San Antonio, TX 78231-2256
Phone (210) 464-3982

Other identifiers 1

IdentifierTypeStateIssuer
MA 1487063MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060914000121 TX Practitioner - Family Practice 9537163068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

13722 Embassy Row
San Antonio, TX 78216-2000
Phone (726) 207-3656

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M4645TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
TMC Provider Group PLLC Current Accepting new patients
TMC Provider Group PLLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

11811 Blanco Rd
San Antonio, TX 78216
Phone (210) 341-5588

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

23611 Ih 10 W
Ste 101
San Antonio, TX 78257
Phone (210) 698-6617

Organizations & group practices 4

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289001600000",
    "number": "1265497945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13218 TRENTWOOD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312256",
            "telephone_number": "210-464-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13218 TRENTWOOD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312256",
            "telephone_number": "210-464-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2010-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA 1487063",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.