Individual provider Active NPI

Michael M Weinik, DO

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1497743694
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0S006020L Issued in PA
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-3646
Fax
(215) 707-6594
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0S006020L PA Primary

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-3646

Other practice location 1

3401 N Broad St
Bsmt, Rock Pavilion
Philadelphia, PA 19140-5103
Phone (215) 707-3646

Other identifiers 1

IdentifierTypeStateIssuer
0011833440001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20031110000109 PA Practitioner - Physical Medicine and Rehabilitation 2163335852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Philadelphia College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Orthopaedic and Sports Medicine Associates, LTDGroup PAC ID 5890681092, 218 clinicians

Practice addresses (Care Compare)

834 Chestnut St
Suite G114
Philadelphia, PA 19107-5114
Phone (215) 521-3001

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S006020LPAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD Physical Medicine & Rehabilitation CurrentSince Apr 1, 2023 Accepting new patients
Fka PHC, LLP CurrentSince Jul 1, 2019 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Apr 1, 2023 Accepting new patients
Temple University of the Commonwealth System of Higher Education Physical Medicine & Rehabilitation PastSince Dec 15, 2019 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

950 Pulaski Dr
#100
Kng of Prussa, PA 19406
Phone (610) 768-4466

834 Chestnut St
Ste G114
Philadelphia, PA 19107
Phone (215) 521-3000

Interoperability endpoints

  • Direct secure messaging: michael.weinik.1@22724.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1497743694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-3646",
            "fax_number": "215-707-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-3646",
            "fax_number": "215-707-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_2": "Bsmt, Rock Pavilion",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-3646",
            "fax_number": "215-707-6594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEINIK",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "0S006020L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011833440001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.