Individual provider Active NPI

Joseph Alexander Weimer, CRNA

  • Certified Registered Nurse Anesthetist
  • Oak Creek, WI
National Provider Identifier
1477115491
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10039-33 Issued in WI
Practice address
2160 E Hidden Creek CT Apt 205
Oak Creek, WI 53154-4412
Phone
(262) 378-0275
NPI assigned
Jun 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 194025-30 WI
Certified Registered Nurse Anesthetist 367500000X 10039-33 WI Primary

Addresses

Primary practice location

2160 E Hidden Creek CT Apt 205
Oak Creek, WI 53154-4412

Mailing address

2160 E Hidden Creek CT Apt 205
Oak Creek, WI 53154-4412
Phone (262) 378-0275

Other practice location 1

2079 S 1200 E Unit 409
Salt Lake City, UT 84105-3584
Phone (262) 378-0275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200518000666 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567898083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
194025-30WIMDRegistered Nurse
10039-33WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sauk Prairie Healthcare, Inc. CurrentSince Nov 11, 2024 Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 3, 2020 Accepting new patients
Sauk Prairie Healthcare Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 11, 2024 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients

Locations

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

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 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": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1477115491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 E HIDDEN CREEK CT APT 205",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544412",
            "telephone_number": "262-378-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 E HIDDEN CREEK CT APT 205",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544412",
            "telephone_number": "262-378-0275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2079 S 1200 E Unit 409",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841053584",
            "country_code": "US",
            "telephone_number": "262-378-0275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "JOSEPH",
        "middle_name": "ALEXANDER",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-29",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "194025-30",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "10039-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.