Individual provider Active NPI

Noah Kawika Weisberg, MD

  • Dermatology Physician
  • Jupiter, FL
National Provider Identifier
1568449031
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME85020 Issued in FL
Practice address
4601 Military TRL
Suite 203
Jupiter, FL 33458-4834
Phone
(561) 775-6011
Fax
(561) 775-6044
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X ME85020 FL
Dermatology Physician 207N00000X ME85020 FL Primary

Addresses

Primary practice location

4601 Military TRL
Suite 203
Jupiter, FL 33458-4834

Mailing address

103 Remo PL
Palm Beach Gardens, FL 33418-1740
Phone (615) 352-9798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110120000139 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 6507045705

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME85020FLMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PBD&P Inc Dermatology CurrentSince May 28, 1998 Accepting new patients
Douglas K Pierce MD PA PastSince Dec 13, 2022 Accepting new patients

Locations

4601 Military Trl
Ste 203
Jupiter, FL 33458
Phone (561) 775-6011

3401 Pga Blvd
Ste 420
Palm Beach Gardens, FL 33410
Phone (561) 471-1808

701 Northpoint Pkwy
Ste 300
West Palm Beach, FL 33407
Phone (561) 863-1000

470 Columbia Dr
Ste A102
West Palm Beach, FL 33409
Phone (561) 640-4400

Interoperability endpoints

  • FHIR API: https://pbd.mmi.prod.fhir.ema-api.com/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1568449031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 REMO PL",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334181740",
            "telephone_number": "615-352-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MILITARY TRL",
            "address_2": "SUITE 203",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584834",
            "telephone_number": "561-775-6011",
            "fax_number": "561-775-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBERG",
        "first_name": "NOAH",
        "middle_name": "KAWIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME85020",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME85020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.