Active NPI
Michael D. Weinberg, O.D.
- Optometrist
- Memphis, TN
National Provider Identifier
1770578403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1765
- Practice address
- 242 S Cooper St
Memphis, TN 38104-4214 - Phone
- (901) 276-3937
- NPI assigned
- Sep 19, 2005
- Last updated
- Feb 17, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1765 | TN | Primary |
Addresses
Primary practice location
242 S Cooper St
Memphis, TN 38104-4214
Mailing address
242 S Cooper St
Memphis, TN 38104-4214
Phone (901) 276-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4099644 | Other | TN | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optical Outlet, Inc | Past | Accepting new patients | |
| Dr. Kenneth a. Weinberg & Assoc P.a. | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Memphis, TN
- NPI 1225212038
-
dba Dr. Kenneth A. Weinberg
- Corneal and Contact Management Optometrist
- Memphis, TN
- NPI 1609032614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234828800000",
"number": "1770578403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 S COOPER ST",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381044214",
"telephone_number": "901-276-3937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 S COOPER ST",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381044214",
"telephone_number": "901-276-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINBERG",
"first_name": "MICHAEL",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2009-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "1765",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "4099644",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.