Individual provider Active NPI

Michael James Weindorf, DPM

  • Podiatrist
  • Salem, OR
National Provider Identifier
1356838825
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP206331 Issued in OR
Practice address
1797 Timberline LN SE
Salem, OR 97306-9564
Phone
(833) 469-2692
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP206331 OR Primary

Addresses

Primary practice location

1797 Timberline LN SE
Salem, OR 97306-9564

Mailing address

1797 Timberline LN SE
Salem, OR 97306-9564
Phone (833) 469-2692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20221229000001 OR Practitioner - Podiatry 8820345978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridge City Foot and Ankle LLCGroup PAC ID 3577975762, 3 clinicians

Practice addresses (Care Compare)

4770 SW Watson Ave
Beaverton, OR 97005-0511
Phone (503) 427-8967

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue103
Removal of skin lesions200
Removal of nail tissue2234
Removal or shaving of skin growth1370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP206331ORMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge City Foot & Ankle LLC Podiatrist CurrentSince Oct 23, 2023 Accepting new patients

Locations

4770 SW Watson Ave
Beaverton, OR 97005
Phone (503) 427-8967

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24143/brand/1/csg/1/fhir/r4

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1356838825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 TIMBERLINE LN SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069564",
            "telephone_number": "833-469-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 TIMBERLINE LN SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069564",
            "telephone_number": "833-469-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINDORF",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP206331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.