Individual provider Active NPI

Hans Edwin Weih, PA

  • Medical Physician Assistant
  • Oakridge, OR
National Provider Identifier
1679636484
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00421 Issued in OR
Practice address
48134 Hwy 58
Oakridge, OR 97463
Phone
(541) 782-4068
Fax
(541) 782-4113
NPI assigned
Dec 19, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00421 OR Primary

Addresses

Primary practice location

48134 Hwy 58
Oakridge, OR 97463

Mailing address

78075 High Prairie Rd
Oakridge, OR 97463-9603
Phone (541) 782-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000842 OR Practitioner - Physician Assistant 5092855809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00421ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Apr 19, 2017 Accepting new patients
Icco LLC CurrentSince Apr 19, 2017 Accepting new patients

Locations

1292 High St
Eugene, OR 97401
Phone (541) 636-3473

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

48134 Highway 58
Oakridge, OR 97463
Phone (541) 556-0525

Organizations & group practices 3

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679636484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78075 HIGH PRAIRIE RD",
            "city": "OAKRIDGE",
            "state": "OR",
            "postal_code": "974639603",
            "telephone_number": "541-782-4068",
            "fax_number": "541-782-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48134 HWY 58",
            "city": "OAKRIDGE",
            "state": "OR",
            "postal_code": "97463",
            "telephone_number": "541-782-4068",
            "fax_number": "541-782-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIH",
        "first_name": "HANS",
        "middle_name": "EDWIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA00421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakridge, OR

Sources for this page

Verify at the official NPI Registry.