Individual provider Active NPI

Paul L Weiden, MD

  • Hematology & Oncology Physician
  • Juneau, AK
National Provider Identifier
1679583256
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4185 Issued in AK
Practice address
3260 Hospital Dr
Juneau, AK 99801
Phone
(907) 796-8631
Fax
(907) 796-8455
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4185 AK Primary

Addresses

Primary practice location

3260 Hospital Dr
Juneau, AK 99801

Mailing address

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8631

Other identifiers 1

IdentifierTypeStateIssuer
MD4752MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20110317000892 AK Practitioner - Hematology/Oncology 2567539711 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4185AKMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlett Regional Hospital CurrentSince Jul 28, 2016 Accepting new patients

Locations

3268 Hospital Dr
Ste B
Juneau, AK 99801
Phone (907) 586-1717

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

1701 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 586-5762

Organizations & group practices 1

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679583256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-796-8631",
            "fax_number": "907-796-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-796-8631",
            "fax_number": "907-796-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDEN",
        "first_name": "PAUL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AK",
            "license": "4185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD4752",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.