Individual provider Active NPI

Mitchell John Weeman, MD

  • Emergency Medicine Physician
  • Cocoa Beach, FL
National Provider Identifier
1609404565
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
160791 Issued in FL
Practice address
701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone
(321) 799-7111
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 160791 FL Primary

Addresses

Primary practice location

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585

Mailing address

1775 W Hibiscus Blvd Ste 215
Melbourne, FL 32901-2627
Phone (321) 837-3825

Other practice location 1

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9000

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
I20230724001828 FL Practitioner - Emergency Medicine 1759785744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wright State University Boonshoft School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone (321) 799-7111

Hospital & facility affiliations

  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160791FLMDEmergency Medicine Physician
R5393KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC CurrentSince Jul 26, 2023 Accepting new patients
Brevard Physician Associates, PLLC Emergency Medicine CurrentSince Jul 26, 2023 Accepting new patients

Locations

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1775 W Hibiscus Blvd
Ste 215
Melbourne, FL 32901
Phone (321) 255-9671

8745 N Wickham Rd
Viera, FL 32940
Phone (321) 434-7191

Interoperability endpoints

  • Direct secure messaging: mweeman71614@epicdirect.hf.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1609404565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W HIBISCUS BLVD STE 215",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012627",
            "telephone_number": "321-837-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313585",
            "telephone_number": "321-799-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8745 N Wickham Rd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329405997",
            "country_code": "US",
            "telephone_number": "321-434-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEEMAN",
        "first_name": "MITCHELL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "160791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.