NPIMap

Individual provider Active NPI

Brandon Weber, PA-C

  • Physician Assistant
  • Berkley, MI
National Provider Identifier
1760423453
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004060 Issued in MI
Practice address
3309 Thomas Ave
Berkley, MI 48072-3160
Phone
(248) 346-4025
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004060 MI Primary

Addresses

Primary practice location

3309 Thomas Ave
Berkley, MI 48072-3160

Mailing address

2075 Oakshire Ave
Berkley, MI 48072-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428000241 MI Practitioner - Physician Assistant 8022005412 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onsight IncGroup PAC ID 6507938800, 27 clinicians

Practice addresses (Care Compare)

2567 W Grand Blvd
Boulevard Temple
Detroit, MI 48208-1235
Phone (313) 895-5340

Merit-based Incentive Payment System (MIPS)

Final score
70.84 of 100Reported as group
Quality
85.89
Promoting interoperability
0
Improvement activities
40
Cost
66.9

Merit-based Incentive Payment System (MIPS)

Final score
92.82 of 100Reported as group
Quality
61.63
Promoting interoperability
100
Improvement activities
40
Cost
81.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004060MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Onsight, Inc. CurrentSince Dec 20, 2023 Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients
Onsight, Inc. Past Accepting new patients
Labaza Eyecare, P.C. Past Accepting new patients
James H. Aronovitz, DO PLLC Past Accepting new patients
Giaimo Mobile Podiatry of WV PLLC Past Accepting new patients
Mobile Medical Inc Past Accepting new patients

Locations

601 Abbott Rd
East Lansing, MI 48823
Phone 24852821166

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1760423453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 OAKSHIRE AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 THOMAS AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723160",
            "telephone_number": "248-346-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "BRANDON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.