Individual provider Active NPI

Timothy John Weibel, MD

  • Plastic Surgery Physician
  • San Jose, CA
National Provider Identifier
1548296437
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G062182 Issued in CA
Practice address
175 N Jackson Ave
Suite 102
San Jose, CA 95116-1909
Phone
(408) 729-9100
Fax
(408) 729-9158
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G062182 CA Primary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X G062182 CA

Addresses

Primary practice location

175 N Jackson Ave
Suite 102
San Jose, CA 95116-1909

Mailing address

1112 Capri Drive
Campbell, CA 95008-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120309000365 CA Practitioner - Plastic and Reconstructive Surgery 1557535861 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Hahnemann University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

175 N Jackson Ave
Suite 102
San Jose, CA 95116-1909
Phone (408) 374-8959

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G062182CAMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Aesthetic and Plastic Surgery Medical Center Plastic Surgery PastSince Dec 30, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tweibel231599@santaclaravalley.direct-ci.net

Organizations & group practices 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1548296437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 CAPRI DRIVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N JACKSON AVE",
            "address_2": "SUITE 102",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161909",
            "telephone_number": "408-729-9100",
            "fax_number": "408-729-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBEL",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G062182",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "G062182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.