Active NPI
Igor Weisz, M.D.
- Psychiatry Physician
- Greenbrae, CA
National Provider Identifier
1417070822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A53529
- Practice address
- 250 Bon Air Rd
Greenbrae, CA 94904-1702 - Phone
- (415) 499-6835
- Fax
- (415) 507-4113
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A53529 | CA | Primary |
Addresses
Primary practice location
250 Bon Air Rd
Greenbrae, CA 94904-1702
Mailing address
250 Bon Air Road
Greenbrae, CA 94904-1702
Phone (415) 499-6835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A53529 | Other | CA | CA LICENSE |
Other names 1
- Dr. Igor Weisz
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 3, 2026 through Feb 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A53529 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1417070822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BON AIR ROAD",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949041702",
"telephone_number": "415-499-6835",
"fax_number": "415-507-4113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BON AIR RD",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949041702",
"telephone_number": "415-499-6835",
"fax_number": "415-507-4113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISZ",
"first_name": "IGOR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A53529",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA LICENSE",
"identifier": "A53529",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "IGOR",
"last_name": "WEISZ",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.