NPIMap

Individual provider Active NPI

Jonathan Randolph Weese, MD

  • Urology Physician
  • Saint Louis, MO
National Provider Identifier
1699125518
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2021016379 Issued in MO
Practice address
12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288
Phone
(314) 543-5270
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2021016379 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288

Mailing address

12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288
Phone (314) 543-5270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810003332 MO Practitioner - Urology 2365846557 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Urology LLCGroup PAC ID 5395768253, 26 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 260
Saint Louis, MO 63128-3288
Phone (314) 251-8850

1965 S Fremont Ave
370 MC Urology S Fremont
Springfield, MO 65804-2284
Phone (417) 820-0300

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 1, 2025 Accepting new patients
Mercy Clinic Urology LLC Urology CurrentSince Aug 2, 2021 Accepting new patients

Locations

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

607 S New Ballas Rd
Ste 3100
Saint Louis, MO 63141
Phone (314) 251-4260

12700 Southfork Rd
Ste 260
Saint Louis, MO 63128
Phone (314) 251-8850

1965 S Fremont Ave
Ste 370
Springfield, MO 65804
Phone (417) 820-0300

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1699125518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283288",
            "telephone_number": "314-543-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283288",
            "telephone_number": "314-543-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEESE",
        "first_name": "JONATHAN",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2021016379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.