Brandon Michael Weaver, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

008798-1 Issued in NY

Practice address

510 S 4TH St Ste 140
Fulton, NY 13069-2952

Phone

(315) 592-3930

Fax

(315) 592-3932

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oswego Hospital Hospital, Oswego, NY, CCN 330218

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Physician Care PC

  • Internal Medicine Physician
  • Oswego, NY
  • NPI 1073868113
  Medicare reassignment Care Compare group
• Greece Dermatological Associates, PC

  • Dermatology Physician
  • Rochester, NY
  • NPI 1437244498
  NPD (past)

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

• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1730220500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511",
            "fax_number": "315-349-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S 4TH ST STE 140",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692952",
            "telephone_number": "315-592-3930",
            "fax_number": "315-592-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008798-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Walter, LPN
• Donna Warren
• Christina Watchus
• Amy Waters, RN
• Sarah June Watson
• Catherine Estelle Welch, LPN
• Eileen Welch, LMSW, LMSW-C
• Sarah Lynn Wendell, LMHC, LPC-MHSP
• Renee S White, RPH
• Paula Ann Marie Whitehouse, RN

• Medical Physician Assistant in Fulton, NY
• Providers in Fulton, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.

Verify at the official NPI Registry.