NPIMap

Individual provider Active NPI

John Weitlich, M.D.

  • Orthopaedic Surgery Physician
  • Columbia, MO
National Provider Identifier
1417339623
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2020021403 Issued in MO
Practice address
1100 Virginia St
Columbia, MO 65212-0001
Phone
(573) 882-5731
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2020021403 MO Primary

Addresses

Primary practice location

1100 Virginia St
Columbia, MO 65212-0001

Mailing address

3107 Frederick Ave
Ste B
Saint Joseph, MO 64506-3082
Phone (816) 233-9888

Other identifiers 1

IdentifierTypeStateIssuer
2015020393OtherMOMISSOURI LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807000804 MO Practitioner - Orthopedic Surgery 8022326909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Sports Medicine Center LLCGroup PAC ID 5294700449, 20 clinicians

Practice addresses (Care Compare)

3107 Frederick Ave
Suite B
Saint Joseph, MO 64506-3082
Phone (816) 233-9888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.54 of 100Reported as group
Quality
89.08
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Association Current Accepting new patients
Orthopedic & Sports Medicine Center, LLC Orthopaedic Surgery CurrentSince Jul 1, 2020 Accepting new patients
Orthopedic & Sports Medicine Center LLC Orthopaedic Surgery CurrentSince Jul 1, 2020 Accepting new patients
Community Hospital Association Past Accepting new patients

Locations

26136 US Highway 59
Fairfax, MO 64446
Phone (660) 686-2211

3107 Frederick Ave
Ste B
Saint Joseph, MO 64506
Phone (816) 233-9888

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 6

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1417339623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 FREDERICK AVE",
            "address_2": "STE B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063082",
            "telephone_number": "816-233-9888",
            "fax_number": "816-233-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VIRGINIA ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITLICH",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2020021403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "2015020393",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.