Individual provider Active NPI

Michael Weiss, M.D.

  • Gastroenterology Physician
  • Fort Myers, FL
National Provider Identifier
1568445955
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME0055049 Issued in FL
Practice address
4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543
Phone
(239) 275-8882
Fax
(239) 939-1330
NPI assigned
Nov 21, 2005
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME0055049 FL Primary

Addresses

Primary practice location

4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543

Mailing address

4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543
Phone (239) 275-8882

Other identifiers 9

IdentifierTypeStateIssuer
5128504OtherFLAETNA
2400973OtherFLGHI
251891100MedicaidFL
110113857OtherFLRAILROAD MEDICARE
1331050OtherFLUNITED HEALTHCARE
1888701OtherFLCIGNA
248308OtherFLAVMED
1568445955OtherFLTRICARE
27600OtherFLBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinical@giaswfl.directbygreenway.com Direct Gastroenterology Associates of Southwest Florida LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0055049FLMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1568445955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 BARKLEY CIR",
            "address_2": "BLDG A",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339077543",
            "telephone_number": "239-275-8882",
            "fax_number": "239-939-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 BARKLEY CIR",
            "address_2": "BLDG A",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339077543",
            "telephone_number": "239-275-8882",
            "fax_number": "239-939-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0055049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5128504",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2400973",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251891100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110113857",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1331050",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1888701",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "248308",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1568445955",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinical@giaswfl.directbygreenway.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Message Address",
            "affiliationName": "Gastroenterology Associates of Southwest Florida LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4790 Barkley Cir",
            "address_2": "BLDG A",
            "city": "Ft Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339077543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.