NPIMap

Individual provider Active NPI

Philip Louis Weidner II, PA-C

  • Physician Assistant
  • Lewiston, ID
National Provider Identifier
1295037844
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2065 Issued in ID
Practice address
320 Warner Dr
Lewiston, ID 83501-4441
Phone
(208) 743-3523
Fax
(833) 941-3874
NPI assigned
Dec 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60191252 WA
Medical Physician Assistant 363AM0700X PA-2065 ID
Surgical Physician Assistant 363AS0400X PA-2065 ID
Physician Assistant 363A00000X PA-2065 ID Primary

Addresses

Primary practice location

320 Warner Dr
Lewiston, ID 83501-4441

Mailing address

320 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 743-3523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110128000609 WA Practitioner - Physician Assistant 5496934903 Reassigns benefits to 2 organizations
I20210715000393 ID Practitioner - Physician Assistant 5496934903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Hospital LLCGroup PAC ID 8325325806, shared by 6 NPIs, 91 clinicians
Adam J Olscamp MD PCGroup PAC ID 4284947334, 11 clinicians

Practice addresses (Care Compare)

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (509) 758-5511

1233 N Northwood Ctr CT
Suite 101
Coeur D Alene, ID 83814-6190
Phone (208) 457-4211

320 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 743-3523

8552 N Government Way
Hayden, ID 83835-9280
Phone (208) 457-4211

Hospital & facility affiliations

  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
  • St Mary'S Hospital Hospital, Cottonwood, ID, CCN 131321
  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60191252WAMDPhysician Assistant
PA-2065IDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Adam J Olscamp MD PC Physician Assistant CurrentSince Jul 2, 2021 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients

Locations

1233 N Northwood Center Ct
Ste 101
Coeur D Alene, ID 83814
Phone (208) 215-2450

8552 N Government Way
Hayden, ID 83835
Phone (208) 457-4211

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: pweidner337165@wm.providencedirect.org
  • Direct secure messaging: philip.weidner.1@2944.direct.athenahealth.com
  • Direct secure messaging: philip.weidner.1@28236.direct.athenahealth.com

Organizations & group practices 6

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 10

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": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1295037844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-743-3523",
            "fax_number": "833-941-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-743-3523",
            "fax_number": "833-941-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "PHILIP",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-01",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60191252",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-2065",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-2065",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.