Individual provider Active NPI

Mark A Weight, MD

  • Orthopaedic Surgery of the Spine Physician
  • Idaho Falls, ID
National Provider Identifier
1396827150
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
M9283 Issued in ID
Practice address
2355 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 523-0303
Fax
(208) 523-9815
NPI assigned
Oct 20, 2006
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X M9283 ID Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X M9283 ID
Orthopaedic Trauma Physician 207XX0801X M9283 ID

Addresses

Primary practice location

2355 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

PO Box 1432
Idaho Falls, ID 83403-1432
Phone (208) 552-8770

Other identifiers 1

IdentifierTypeStateIssuer
807238300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20050929000567 ID Practitioner - Orthopedic Surgery 9739159187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
R Franklin University of Med & Sci/Chicago Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2355 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 523-0303

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion109
Laminectomy or laminotomy (partial removal of spine bones)52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9283IDMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn J Stromberg MD PA Orthopaedic Surgery CurrentSince Apr 1, 2019 Accepting new patients
Mark a Weight MD PC Orthopaedic Surgery CurrentSince Jul 13, 2005 Accepting new patients

Locations

1945 E 17th St
Idaho Falls, ID 83404
Phone (208) 529-1945

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

2355 Coronado St
Idaho Falls, ID 83404
Phone (208) 523-0303

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1396827150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1432",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031432",
            "telephone_number": "208-552-8770",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-523-0303",
            "fax_number": "208-523-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGHT",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "ID",
            "license": "M9283",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "ID",
            "license": "M9283",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "ID",
            "license": "M9283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807238300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.