Malcolm D Weiss, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS002826L Issued in PA

Practice address

4633 Riverwalk Village CT
Ponce Inlet, FL 32127-2700

Phone

(717) 870-2244

NPI assigned

Feb 12, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Memorial Enterprises Inc

  dba Memorial Primary Care Network

  • Family Medicine Physician
  • York, PA
  • NPI 1275734345
  NPD (past)

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1639538069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 RIVERWALK VILLAGE CT",
            "city": "PONCE INLET",
            "state": "FL",
            "postal_code": "321272700",
            "telephone_number": "717-870-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 RIVERWALK VILLAGE CT",
            "city": "PONCE INLET",
            "state": "FL",
            "postal_code": "321272700",
            "telephone_number": "717-870-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MALCOLM",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS002826L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris O'Brien, R PH
• Kerry Leonard Pazos, DMD
• Porter Pelvic Physical Therapy
• Jinny E Ruhlman
• Charles Edward Sternberg
• Rebecca Elizabeth Wuamett

• Family Medicine Physician in Ponce Inlet, FL
• Providers in Ponce Inlet, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.