Individual provider Active NPI

Modern Weng, D.O.

  • Internal Medicine Physician
  • Mountain View, CA
National Provider Identifier
1407888944
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10477 Issued in CA
Practice address
1600 Amphitheatre Pkwy
Mountain View, CA 94043-1351
Phone
(650) 227-1102
Fax
(650) 227-1107
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 226739 MA
Internal Medicine Physician 207R00000X 20A10477 CA Primary

Addresses

Primary practice location

1600 Amphitheatre Pkwy
Mountain View, CA 94043-1351

Mailing address

746 The Alameda
Suite 10
San Jose, CA 95126-3154
Phone (408) 228-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081128000037 CA Practitioner - Internal Medicine 2961562509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

1144 S 2ND St
San Jose, CA 95112-5974
Phone (408) 961-4700

1887 Monterey Hwy
Suite 205
San Jose, CA 95112-6192
Phone (408) 961-4040

1991 McKee Rd
San Jose, CA 95116-1406
Phone (408) 885-7366

1993 McKee Rd
San Jose, CA 95116-1406
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10477CAMDInternal Medicine Physician
226739MAMDInternal Medicine Physician
10477CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Apr 1, 2020 Accepting new patients
County of Santa Clara CurrentSince Apr 1, 2020 Accepting new patients
County of Santa Clara Internal Medicine Current Accepting new patients
County of Santa Clara CurrentSince Apr 1, 2020 Accepting new patients
County of Santa Clara CurrentSince Apr 1, 2020 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: mweng153285@santaclaravalley.direct-ci.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1407888944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 THE ALAMEDA",
            "address_2": "SUITE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263154",
            "telephone_number": "408-228-1020",
            "fax_number": "408-228-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 AMPHITHEATRE PKWY",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431351",
            "telephone_number": "650-227-1102",
            "fax_number": "650-227-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENG",
        "first_name": "MODERN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "226739",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.