Individual provider Active NPI

Michael J Weir, CRNA

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
National Provider Identifier
1679555049
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN257854L Issued in PA
Practice address
5100 W Tilghman St Ste 315
Allentown, PA 18104-9166
Phone
(610) 395-4044
Fax
(610) 395-5693
NPI assigned
Nov 18, 2005
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN257854L PA Primary

Addresses

Primary practice location

5100 W Tilghman St Ste 315
Allentown, PA 18104-9166

Mailing address

PO Box 783497
Philadelphia, PA 19178-3497
Phone (610) 395-4044

Other identifiers 1

IdentifierTypeStateIssuer
001239717MedicaidPA

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN257854LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hershey Endoscopy Center, LLC CurrentSince Jan 15, 2014 Accepting new patients
Blair County Anesthesia, P.C. Past Accepting new patients
Ridley Crossings Surgical Center Past Accepting new patients
Lisa S. Bunin, M.D. Past Accepting new patients
Lexington Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

905 W Governor Rd
Ste 100
Hershey, PA 17033
Phone (717) 531-1318

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1679555049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783497",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783497",
            "telephone_number": "610-395-4044",
            "fax_number": "610-395-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TILGHMAN ST STE 315",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049166",
            "telephone_number": "610-395-4044",
            "fax_number": "610-395-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIR",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN257854L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001239717",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.