Individual provider Active NPI

Robert Bernard Weber, M.D.

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1619981636
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G30439 Issued in CA
Practice address
12099 W Washington Blvd Ste 300
Los Angeles, CA 90066-2621
Phone
(310) 558-9777
Fax
(310) 558-9778
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G30439 CA Primary

Addresses

Primary practice location

12099 W Washington Blvd Ste 300
Los Angeles, CA 90066-2621

Mailing address

PO Box 17763
Beverly Hills, CA 90209-3763
Phone (310) 558-9777

Other identifiers 2

IdentifierTypeStateIssuer
00G304391MedicaidCA
G3043913OtherCAMEDICARE ID

Other names 1

  • Robert Bernard Weber Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120203000759 CA Practitioner - General PracticePractitioner - Cardiovascular Disease (Cardiology) 6507760030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30439CAMDChiropractor

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Hollywood Diagnostic Service CurrentSince Apr 15, 2012 Accepting new patients
Progressive Medical Imaging, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Professional Imaging Network Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1619981636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17763",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902093763",
            "telephone_number": "310-558-9777",
            "fax_number": "310-558-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12099 W WASHINGTON BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900662621",
            "telephone_number": "310-558-9777",
            "fax_number": "310-558-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "ROBERT",
        "middle_name": "BERNARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G30439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G304391",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "G3043913",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "WEBER",
            "middle_name": "BERNARD",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.