Individual provider Active NPI

Patrick J Weires, DPM

  • Foot & Ankle Surgery Podiatrist
  • Waterloo, IA
National Provider Identifier
1316936628
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00449 Issued in IA
Practice address
927 W 4TH St
Waterloo, IA 50702-2801
Phone
(319) 233-6107
Fax
(319) 233-9138
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00449 IA Primary

Addresses

Primary practice location

927 W 4TH St
Waterloo, IA 50702-2801

Mailing address

927 W 4TH St
Waterloo, IA 50702-2801
Phone (319) 233-6107

Other identifiers 1

IdentifierTypeStateIssuer
1239319MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100805000900 IA Practitioner - Podiatry 7416949698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.42 of 100Reported as group
Quality
78.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00449IAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot Health Care PLC Foot & Ankle Surgery CurrentSince Jul 1, 2003 Accepting new patients
Family Foot Health Care PLC Foot & Ankle Surgery CurrentSince Jul 1, 2000 Accepting new patients

Locations

502 3rd St
Parkersburg, IA 50665
Phone (319) 346-2331

927 W 4th St
Waterloo, IA 50702
Phone (319) 233-3691

Organizations & group practices 2

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1316936628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 W 4TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022801",
            "telephone_number": "319-233-6107",
            "fax_number": "319-233-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 W 4TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022801",
            "telephone_number": "319-233-6107",
            "fax_number": "319-233-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIRES",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IA",
            "license": "00449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1239319",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.