NPIMap

Individual provider Active NPI

Paul S Weinberg, MD

  • Emergency Medicine Physician
  • Kotzebue, AK
National Provider Identifier
1609804426
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G27031 Issued in CA
Practice address
436 5TH & Ted Stevens Way
Kotzebue, AK 99752-0043
Phone
(907) 442-3321
Fax
(907) 442-7250
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G27031 CA Primary

Addresses

Primary practice location

436 5TH & Ted Stevens Way
Kotzebue, AK 99752-0043

Mailing address

18620 E Cactus Hill Rd
Vail, AZ 85641-6212
Phone (805) 712-6613

Other identifiers 3

IdentifierTypeStateIssuer
HS19IPMedicaidAK
OOG270310MedicaidCA
HS19OPMedicaidAK

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
G27031CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Banks Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Main Street Emergency Physicians Medical Group Inc Emergency Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients
Gustavus Community Clinic Inc Past Accepting new patients
White Trillium Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients

Organizations & group practices 6

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1609804426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18620 E CACTUS HILL RD",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856416212",
            "telephone_number": "805-712-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 5TH & TED STEVENS WAY",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520043",
            "telephone_number": "907-442-3321",
            "fax_number": "907-442-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERG",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G27031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS19IP",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG270310",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS19OP",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.