Individual provider Active NPI

Dennis D Weisenburger, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Duarte, CA
National Provider Identifier
1699727883
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G38421 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(626) 256-4673
Fax
(626) 301-8842
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 16584 NE
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G38421 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185
Phone (626) 775-3514

Other identifiers 1

IdentifierTypeStateIssuer
47078557547MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CA2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100128000917 NE Practitioner - Pathology 5890837850 Reassigns benefits to 1 organization
I20121015000283 CA Practitioner - Pathology 5890837850 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16584NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Apr 4, 2022 Accepting new patients
City of Hope Medical Foundation Anatomic Pathology & Clinical Pathology CurrentSince Sep 17, 2012 Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Interoperability endpoints

  • Direct secure messaging: dweisenburger9512@direct.nebraskamed.com
  • Direct secure messaging: direct@cityofhope.direct-ci.com

Organizations & group practices 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1699727883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185",
            "telephone_number": "626-775-3514",
            "fax_number": "626-218-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-256-4673",
            "fax_number": "626-301-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISENBURGER",
        "first_name": "DENNIS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "16584",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G38421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078557547",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.