Individual provider Active NPI

Brock Brandon Weedman, PSY D

  • Psychologist
  • Bellevue, WA
National Provider Identifier
1558346502
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00003318 Issued in WA
Practice address
2820 Northup Way
Suite 105
Bellevue, WA 98004-1419
Phone
(425) 213-2848
Fax
(425) 576-0654
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY00003318 WA Primary

Addresses

Primary practice location

2820 Northup Way
Suite 105
Bellevue, WA 98004-1419

Mailing address

2820 Northup Way
Suite 105
Bellevue, WA 98004-1419
Phone (425) 213-2848

Other identifiers 1

IdentifierTypeStateIssuer
8902991OtherWACRIME VICTIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061113000398 WA Practitioner - Clinical Psychologist 7315945037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2820 Northup Way
Suite 105
Bellevue, WA 98004-1438
Phone (425) 213-2848

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Links Consulting PLLC Psychologist CurrentSince Apr 30, 2003 Accepting new patients

Locations

2820 Northup Way
Ste 105
Bellevue, WA 98004
Phone (425) 822-8153

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558346502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 NORTHUP WAY",
            "address_2": "SUITE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041419",
            "telephone_number": "425-213-2848",
            "fax_number": "425-576-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 NORTHUP WAY",
            "address_2": "SUITE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041419",
            "telephone_number": "425-213-2848",
            "fax_number": "425-576-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDMAN",
        "first_name": "BROCK",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00003318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8902991",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.