Individual provider Active NPI

Richard S Weiss, D.O.

  • Family Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1568568459
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS13555 Issued in FL
Practice address
3918 Via Poinciana
Ste 8
Lake Worth, FL 33467-2991
Phone
(561) 996-4370
Fax
(561) 641-2484
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB041575 NJ
Family Medicine Physician 207Q00000X OS004765L PA
Family Medicine Physician 207Q00000X OS13555 FL Primary

Addresses

Primary practice location

3918 Via Poinciana
Ste 8
Lake Worth, FL 33467-2991

Mailing address

5700 Lake Worth Rd
Ste 204
Greenacres, FL 33463-4727
Phone (561) 966-7703

Other identifiers 1

IdentifierTypeStateIssuer
1739301MedicaidNJ

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
I20160422001062 FL Practitioner - Family Practice 9133020381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB041575NJMDFamily Medicine Physician
OS004765LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rowansom Dept of Pediatrics Past Accepting new patients

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1568568459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 LAKE WORTH RD",
            "address_2": "STE 204",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634727",
            "telephone_number": "561-966-7703",
            "fax_number": "561-649-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3918 VIA POINCIANA",
            "address_2": "STE 8",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672991",
            "telephone_number": "561-996-4370",
            "fax_number": "561-641-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "RICHARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB041575",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004765L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1739301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.