Individual provider Active NPI

Daniel Mark Weiland, PA-C, MMSC, MS

  • Surgical Physician Assistant
  • Bend, OR
National Provider Identifier
1679650436
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
004749 Issued in GA
Practice address
2500 NE Neff Rd
Bend, OR 97701-6015
Phone
(541) 388-4333
Fax
(541) 388-3446
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 004749 GA Primary

Addresses

Primary practice location

2500 NE Neff Rd
Bend, OR 97701-6015

Mailing address

Emory University Hospital
1365 Clifton Road
Atlanta, GA 30322-0001
Phone (404) 821-7273

Other practice location 1

Emory University Hospital
1365 Clifton Road
Atlanta, GA 30322-0001
Phone (404) 821-7273

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dweiland46702@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100525001008 GA Practitioner - Physician Assistant 3072642396 Reassigns benefits to 2 organizations
I20180524001256 OR Practitioner - Physician Assistant 3072642396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

2500 NE Neff Rd
Bend, OR 97701-6015

Hospital & facility affiliations

  • St. Charles Home Health Services Home health agency, Bend, OR, CCN 387026
  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • St Charles Madras Hospital, Madras, OR, CCN 381324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
004749GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation CurrentSince Nov 1, 2014 Accepting new patients
St. Charles Health System, Inc. CurrentSince May 21, 2018 Accepting new patients
The Emory Clinic Inc CurrentSince Mar 5, 2010 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Nov 1, 2014 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

29358 Network Pl
Chicago, IL 60673

1345 NW Wall St
Ste 200
Bend, OR 97703
Phone (541) 330-2103

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: dweiland46702@secure.stcharleshealthcare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1679650436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EMORY UNIVERSITY HOSPITAL",
            "address_2": "1365 CLIFTON ROAD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-821-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-388-4333",
            "fax_number": "541-388-3446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Emory University Hospital",
            "address_2": "1365 Clifton Road",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303220001",
            "country_code": "US",
            "telephone_number": "404-821-7273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEILAND",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA-C, MMSC, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "004749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dweiland46702@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2500 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.