Individual provider Active NPI

Paul David Weiner

  • Foot & Ankle Surgery Podiatrist
  • Vallejo, CA
National Provider Identifier
1730167370
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3880 Issued in CA
Practice address
480 Redwood St
Suite 10
Vallejo, CA 94590-2958
Phone
(707) 643-3687
Fax
(707) 643-3077
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3880 CA
Foot & Ankle Surgery Podiatrist 213ES0103X E3880 CA Primary

Addresses

Primary practice location

480 Redwood St
Suite 10
Vallejo, CA 94590-2958

Mailing address

480 Redwood St
Suite 10
Vallejo, CA 94590-2958
Phone (707) 643-3687

Other identifiers 1

IdentifierTypeStateIssuer
000E38800MedicaidCA

Other names 1

  • Paul David Weiner Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120301000754 CA Practitioner - Podiatry 4789794322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Foot Care IncGroup PAC ID 0345329686, 127 clinicians

Practice addresses (Care Compare)

2844 Summit St
Suite 107
Oakland, CA 94609-3641
Phone (510) 581-1484

480 Redwood St
Suite 10
Vallejo, CA 94590-2958
Phone (707) 643-3687

750 Las Gallinas Ave
Suite 115
San Rafael, CA 94903-3431
Phone (415) 472-5575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.65 of 100Reported as group
Quality
68.04
Promoting interoperability
99
Improvement activities
40
Cost
75.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue324
Removal of nail tissue1714
Removal or shaving of skin growth1671
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3880CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Foot Care, Inc Podiatrist CurrentSince Sep 1, 2022 Accepting new patients
Bay Area Foot Care Inc Podiatrist CurrentSince Sep 1, 2022 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1600 Creekside Dr
Ste 3100
Folsom, CA 95630
Phone (916) 269-8865

2844 Summit St
Ste 107
Oakland, CA 94609
Phone (510) 463-3888

1100 Laurel St
Ste E
San Carlos, CA 94070
Phone (650) 595-4148

1580 Valencia St
Ste 109
San Francisco, CA 94110
Phone (415) 285-7711

2114 McKee Rd
San Jose, CA 95116
Phone (408) 272-2211

750 Las Gallinas Ave
Ste 115
San Rafael, CA 94903
Phone (415) 472-5575

480 Redwood St
Ste 10
Vallejo, CA 94590
Phone (707) 643-3687

47 Penny Ln
Ste 1
Watsonville, CA 95076
Phone (831) 728-8844

Interoperability endpoints

  • Direct secure messaging: paul.weiner.1@20181.direct.athenahealth.com
  • Direct secure messaging: pweiner240092@hisp.ehr.sutterhealth.org

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 1

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1730167370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 REDWOOD ST",
            "address_2": "SUITE 10",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902958",
            "telephone_number": "707-643-3687",
            "fax_number": "707-643-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 REDWOOD ST",
            "address_2": "SUITE 10",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902958",
            "telephone_number": "707-643-3687",
            "fax_number": "707-643-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3880",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E38800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "WEINER",
            "middle_name": "DAVID",
            "credential": "D.P.M.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.