Individual provider Active NPI

Travis James Weiss, PA

  • Physician Assistant
  • Cape Girardeau, MO
National Provider Identifier
1699084814
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2010034785 Issued in MO
Practice address
48 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 335-8257
Fax
(573) 335-8424
NPI assigned
Oct 5, 2010
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2010034785 MO Primary

Addresses

Primary practice location

48 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20101110000636 MO Practitioner - Physician Assistant 5597950014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

200 Southland Dr
Sikeston, MO 63801-4403
Phone (573) 472-1770

6724 State Hwy 77
Benton, MO 63736-8238
Phone (573) 545-4200

6738 State Hwy 77
Benton, MO 63736-8238

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Health Network CurrentSince Oct 1, 2010 Accepting new patients
Southeast Missouri Health Network CurrentSince Oct 1, 2010 Accepting new patients
Southeast Missouri Health Network Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

6724 State Highway 77
Benton, MO 63736
Phone (573) 545-4191

6738 State Highway 77
Benton, MO 63736
Phone (573) 313-2500

741 S Walnut St
Bernie, MO 63822
Phone (573) 293-6836

109 E 5th St
Caruthersville, MO 63830
Phone (573) 359-9803

500 Russell St
Kennett, MO 63857
Phone (573) 717-1332

655 US Highway 61
New Madrid, MO 63869
Phone (573) 545-4200

200 Pine St
Sikeston, MO 63801
Phone (573) 313-2500

200 Southland Dr
Sikeston, MO 63801
Phone (573) 472-1770

220 Southland Dr
Sikeston, MO 63801
Phone (573) 471-4167

835 W Murray Ln
Sikeston, MO 63801
Phone (573) 472-8808

Interoperability endpoints

  • Direct secure messaging: travis.weiss.1@14764.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1699084814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-335-8257",
            "fax_number": "573-335-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "TRAVIS",
        "middle_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2010034785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.