Individual provider Active NPI

Miriam F Weiss, M.D.

  • Nephrology Physician
  • Mentor, OH
National Provider Identifier
1336230804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
053552 Issued in OH
Practice address
8300 Tyler Blvd
Suite 102
Mentor, OH 44060-4217
Phone
(440) 266-5000
Fax
(440) 974-1686
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 053552 OH Primary

Addresses

Primary practice location

8300 Tyler Blvd
Suite 102
Mentor, OH 44060-4217

Mailing address

5096 Dogwood TRL
Lyndhurst, OH 44124-2743
Phone (440) 449-8523

Other identifiers 1

IdentifierTypeStateIssuer
0675845MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053552OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Nephrology Care LTD. Nephrology Past Accepting new patients

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336230804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5096 DOGWOOD TRL",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242743",
            "telephone_number": "440-449-8523",
            "fax_number": "440-974-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 TYLER BLVD",
            "address_2": "SUITE 102",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604217",
            "telephone_number": "440-266-5000",
            "fax_number": "440-974-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MIRIAM",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "053552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0675845",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.