Shelley Ethan Weiss, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L0958 Issued in TX

Practice address

7777 Forest LN Ste C550
Dallas, TX 75230-7518

Phone

(972) 566-4286

Fax

(972) 566-8634

NPI assigned

Jul 17, 2006

Last updated

Sep 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelley.weiss.1@8042.direct.athenahealth.com

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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment NPD
• Shelley E. Weiss MD PA

  dba Healthy Texan Pediatrics

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1841419033
  Authorized official Same address or phone
• Texas Health Care, P.L.L.C.

  • Otolaryngology Physician
  • Fort Worth, TX
  • NPI 1245686617
  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD
• Columbia Hospital at Medical City Dallas Subsidiary LP

  dba Medical City Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1699793760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752307518",
            "telephone_number": "972-566-4286",
            "fax_number": "972-566-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "SHELLEY",
        "middle_name": "ETHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L0958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168133001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168133002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariana Jillian Weiss
• Jacob Weiss
• Jerry Weiss, PH.D.
• Joshua L. Weiss, MD
• Michael Weiss, M.D.
• Simma Weiss, M.D.
• Lindsey Lee Weissgarber, MS, CCC-SLP
• Olivia Weisskopf
• Jonathan C Weissler, MD
• Rosalinda Weisz, M.A., L.P.C.

• Pediatrics Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.