Individual provider Active NPI

Jill Marie Weber, DO

  • Family Medicine Physician
  • Phoenixville, PA
National Provider Identifier
1528042629
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS012849 Issued in PA
Practice address
236 Hudson Dr
Phoenixville, PA 19460-5655
Phone
(610) 983-9100
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 268282 NY
Family Medicine Physician 207Q00000X DO00722 RI
Family Medicine Physician 207Q00000X 25MB09254300 NJ
Family Medicine Physician 207Q00000X 036.132263 IL
Family Medicine Physician 207Q00000X 051611 CT
Family Medicine Physician 207Q00000X C2-0008542 DE
Family Medicine Physician 207Q00000X H0063585 MD
Family Medicine Physician 207Q00000X 2815 WV
Family Medicine Physician 207Q00000X 0102203675 VA
Family Medicine Physician 207Q00000X 032.0091528 VT
Family Medicine Physician 207Q00000X 36657 SC
Family Medicine Physician 207Q00000X 34.011192 OH
Family Medicine Physician 207Q00000X 2013-02455 NC
Family Medicine Physician 207Q00000X 16334 NH
Family Medicine Physician 207Q00000X OS012849 PA Primary

Addresses

Primary practice location

236 Hudson Dr
Phoenixville, PA 19460-5655

Mailing address

236 Hudson Dr
Phoenixville, PA 19460-5655
Phone (610) 983-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, ME, CT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090324000424 PA Practitioner - Family Practice 3072535657 Reassigns benefits to 1 organization
I20251209004016 ME Practitioner - Family Practice 3072535657 Reassigns benefits to 1 organization
I20260624000140 CT Practitioner - Family Practice 3072535657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

2595 Interstate Dr
Suite 103
Harrisburg, PA 17110-9378
Phone (800) 997-6196

45 Memorial Cir
Augusta, ME 04330-6400
Phone (800) 997-6196

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36657SCMDPharmacist
051611CTMDFamily Medicine Physician
C2-0008542DEMDFamily Medicine Physician
036.132263ILMDFamily Medicine Physician
H0063585MDMDFamily Medicine Physician
2013-02455NCMDFamily Medicine Physician
16334NHMDFamily Medicine Physician
25MB09254300NJMDFamily Medicine Physician
268282NYMDFamily Medicine Physician
34.011192OHMDFamily Medicine Physician
DO00722RIMDFamily Medicine Physician
0102203675VAMDFamily Medicine Physician
032.0091528VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C Family Medicine CurrentSince Apr 13, 2024 Accepting new patients
Peninsula Regional Medical Center Past Accepting new patients
Peninsual Regional Medical Center Family Medicine Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

45 Memorial Cir
Augusta, ME 04330
Phone (855) 270-3624

2595 Interstate Dr
Ste 103
Harrisburg, PA 17110
Phone (386) 672-4222

Interoperability endpoints

  • Direct secure messaging: jill.weber.1@30520.direct.athenahealth.com

Organizations & group practices 3

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1528042629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 HUDSON DR",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194605655",
            "telephone_number": "610-983-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 HUDSON DR",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194605655",
            "telephone_number": "610-983-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "268282",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00722",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09254300",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.132263",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "051611",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0008542",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0063585",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2815",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102203675",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "032.0091528",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "36657",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.011192",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-02455",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "16334",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

Verify at the official NPI Registry.