Active NPI
Thomas Weiss, PH.D.
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1700954203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 713
- Practice address
- 1814 Greenberry Rd
Baltimore, MD 21209-4537 - Phone
- (410) 578-3999
- Fax
- (410) 578-1087
- NPI assigned
- Dec 1, 2006
- Last updated
- Jul 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 713 | MD | Primary |
Addresses
Primary practice location
1814 Greenberry Rd
Baltimore, MD 21209-4537
Mailing address
1814 Greenberry Rd
Baltimore, MD 21209-4537
Phone (410) 578-3999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56-2383040 | Other | MD | FED TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101103001136 | MD | Practitioner - Clinical Psychologist | 5597959882 | Practice locations: Baltimore, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1814 Greenberry Rd
Baltimore, MD 21209-4537
Phone (410) 578-3999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 713 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1700954203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 GREENBERRY RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094537",
"telephone_number": "410-578-3999",
"fax_number": "410-578-1087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 GREENBERRY RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094537",
"telephone_number": "410-578-3999",
"fax_number": "410-578-1087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "56-2383040",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.