NPIMap

Individual provider Active NPI

Bruce Frank Weber, M.D.

  • Family Medicine Physician
  • Gillespie, IL
National Provider Identifier
1609870591
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
715 Broadway St
Gillespie, IL 62033-1166
Phone
(217) 839-4491
NPI assigned
Jun 8, 2005
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

715 Broadway St
Gillespie, IL 62033-1166

Mailing address

715 Broadway St
Gillespie, IL 62033-1166
Phone (217) 839-4491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000202 IL Practitioner - Family Practice 3173431061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

715 Broadway St
Gillespie, IL 62033-1166
Phone (217) 839-4491

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036066909ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macoupin Family Practice Centers LLP Family Medicine CurrentSince Sep 24, 2002 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Springfield Clinic, LLP PastSince Nov 22, 2004 Accepting new patients

Locations

715 Broadway St
Gillespie, IL 62033
Phone (217) 839-4491

115 N Poplar St
Mount Olive, IL 62069
Phone 2179994751 ext. 94491

Interoperability endpoints

  • Direct secure messaging: bruceweber@macoupinfm.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mount Olive Family Practice CenterMount Olive, IL, CCN 143863 Rural health clinic General Partnership Interest (33.3%) Nov 1, 2002
Gillespie Family Practice CenterGillespie, IL, CCN 143859 Rural health clinic General Partnership Interest (33.3%) Nov 1, 2002
Carlinville Family Practice CenterCarlinville, IL, CCN 148926 Rural health clinic General Partnership Interest Jan 14, 2003

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

Hospital & facility affiliations 11

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1609870591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BROADWAY ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331166",
            "telephone_number": "217-839-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BROADWAY ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331166",
            "telephone_number": "217-839-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "BRUCE",
        "middle_name": "FRANK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillespie, IL

Sources for this page

Verify at the official NPI Registry.