Individual provider Active NPI

Wei-Min Djajadi, M.D.

  • Pediatrics Physician
  • Lubbock, TX
National Provider Identifier
1316175995
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P8351 Issued in TX
Practice address
3601 4TH St FL 3
Lubbock, TX 79430-0002
Phone
(806) 743-7335
Fax
(806) 743-4073
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P8351 TX Primary

Addresses

Primary practice location

3601 4TH St FL 3
Lubbock, TX 79430-0002

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other practice location 1

3601 4th Street
Mail Stop 9406
Lubbock, TX 79430
Phone (806) 743-7337

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address weimin.djajadi@direct.myteamcare.com

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
I20170105000645 TX Practitioner - Pediatric Medicine 2264713213 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P8351TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Nov 18, 2016 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Pediatrics CurrentSince Nov 18, 2016 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
Fl 3
Lubbock, TX 79430
Phone (806) 743-2340

3601 4th St
Stop 9406
Lubbock, TX 79430
Phone (806) 743-6630

Interoperability endpoints

  • Direct secure messaging: wdjajadi38427@direct.chppoc.masshiway.net

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1316175995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST FL 3",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-7335",
            "fax_number": "806-743-4073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th Street",
            "address_2": "Mail Stop 9406",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "79430",
            "country_code": "US",
            "telephone_number": "806-743-7337",
            "fax_number": "806-743-4218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DJAJADI",
        "first_name": "WEI-MIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P8351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "weimin.djajadi@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St Fl 3",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.