Individual provider Active NPI

Judith H Weiss, MD

  • Family Medicine Physician
  • Independence, OH
National Provider Identifier
1376632158
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35052437 Issued in OH
Practice address
6701 Rockside Rd
Suite 260
Independence, OH 44131-2358
Phone
(216) 369-2525
Fax
(216) 369-2531
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16545 NV
Family Medicine Physician 207Q00000X G68883 CA
Family Medicine Physician 207Q00000X 10681A WY
Family Medicine Physician 207Q00000X MD60633801 WA
Family Medicine Physician 207Q00000X 52042 AZ
Family Medicine Physician 207Q00000X MED-PHYS-LIC-44990 MT
Family Medicine Physician 207Q00000X M-13196 ID
Family Medicine Physician 207Q00000X DR.0057080 CO
Family Medicine Physician 207Q00000X MD175712 OR
Family Medicine Physician 207Q00000X MD2016-0808 NM
Family Medicine Physician 207Q00000X 114311 AK
Family Medicine Physician 207Q00000X MD-18905 HI
Family Medicine Physician 207Q00000X 35052437 OH Primary

Addresses

Primary practice location

6701 Rockside Rd
Suite 260
Independence, OH 44131-2358

Mailing address

7350 Industrial Park Blvd
Mentor, OH 44060-5318
Phone (216) 732-9480

Other identifiers 4

IdentifierTypeStateIssuer
0944607MedicaidOH
000000533747OtherOHANTHEM
408442OtherOHWELLCARE
9006404OtherOHSUMMACARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051024000369 OH Practitioner - Family Practice 6507882032 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114311AKMDFamily Medicine Physician
52042AZMDFamily Medicine Physician
G68883CAMDFamily Medicine Physician
DR.0057080COMDFamily Medicine Physician
MD-18905HIMDFamily Medicine Physician
M-13196IDMDFamily Medicine Physician
MED-PHYS-LIC-44990MTMDFamily Medicine Physician
MD2016-0808NMMDFamily Medicine Physician
16545NVMDFamily Medicine Physician
35052437OHMDFamily Medicine Physician
MD175712ORMDFamily Medicine Physician
MD60633801WAMDFamily Medicine Physician
10681AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

3033 Campus Dr
Ste W225
Plymouth, MN 55441
Phone (415) 429-6977

50 W Broad St
Ste 1330
Columbus, OH 43215
Phone (630) 320-6871

Interoperability endpoints

  • Direct secure messaging: judith.weiss.1@30520.direct.athenahealth.com

Organizations & group practices 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1376632158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "SUITE 260",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-369-2525",
            "fax_number": "216-369-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JUDITH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "16545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G68883",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "10681A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60633801",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "52042",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-44990",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-13196",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0057080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD175712",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2016-0808",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "114311",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-18905",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35052437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0944607",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000533747",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "408442",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "9006404",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.