Jeffrey Alan Wieder, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

A71035 Issued in CA

Practice address

2999 Regent St
#612
Berkeley, CA 94705-2146

Phone

(510) 848-1727

Fax

(510) 848-8224

NPI assigned

Nov 29, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Berkeley Urological Associates a Medical Group Inc. Fka Lyon

  • Pediatric Urology Physician
  • Berkeley, CA
  • NPI 1992872410
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1760559264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "#612",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052146",
            "telephone_number": "510-848-1727",
            "fax_number": "510-848-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "#612",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052146",
            "telephone_number": "510-848-1727",
            "fax_number": "510-848-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDER",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CA",
            "license": "A71035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY49005Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikolus Whitmire, PSYD
• Whole Child Psychological Services, PC
• Whole Health Services
• Whole Health Services Acupuncture Corp
• Holly T Wieber, DDS
• Tatiana Wiggins
• Wildflower Seed Integrative Family Medicine
• Landry Wildwind, L.C.S.W.
• Patti L Wiley, MFT
• Anne Carolyn Wilford I, MA MFT

• Pediatric Urology Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pediatric Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.