Jack Robert Weitz, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 4345 Issued in FL

Practice address

1021 Ives Darry Rd
BLDG 3 Suite 119
North Miami Beach, FL 33179

Phone

(305) 655-2335

Fax

(305) 652-5759

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Jack R Weitz PHD PA

  • Psychologist
  • N Miami Beach, FL
  • NPI 1063579662
  Medicare reassignment NPD Authorized official
• Nicola Chung, PH.D., LLC

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1346312923
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407904873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 IVES DARRY RD",
            "address_2": "BLDG 3 SUITE 119",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-655-2335",
            "fax_number": "305-652-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 IVES DARRY RD",
            "address_2": "BLDG 3 SUITE 119",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-655-2335",
            "fax_number": "305-652-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZ",
        "first_name": "JACK",
        "middle_name": "ROBERT",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 4345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• We Are Essential, LLC
• Marc K Weinberg, D.C.
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• Mark L Weiss, DMD, PA
• Mark Weitman, MD
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• Mary Hill Westra, RN, IBCLC
• Whitecaps Dental PA
• Wholistic Recovery LLC

• Psychologist in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Psychologist in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.