Active NPI
Michael Eric Weiss, MD
- Pediatric Emergency Medicine (Pediatrics) Physician
- Hollywood, FL
National Provider Identifier
1780612028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- ME75622
- Practice address
- 3501 Johnson Streeet
Hollywood, FL 33021 - Phone
- (954) 987-2000
- Fax
- (954) 985-3453
- NPI assigned
- Jun 28, 2006
- Last updated
- Mar 29, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME75622 | FL | |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | ME75622 | FL | Primary |
Addresses
Primary practice location
3501 Johnson Streeet
Hollywood, FL 33021
Mailing address
PO Box 635002
Cincinnati, OH 45263-5002
Phone (800) 424-3672
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46732 | Other | FL | BLUE SHIELD |
| 256533100 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mweiss5138@MHSDIRECT.NET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME75622 | FL | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Interoperability endpoints
- mweiss5138@mhsdirect.net
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Hollywood, FL
- NPI 1871521880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1780612028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635002",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635002",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 JOHNSON STREEET",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-987-2000",
"fax_number": "954-985-3453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "MICHAEL",
"middle_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME75622",
"primary": false
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "FL",
"license": "ME75622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "46732",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "256533100",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mweiss5138@MHSDIRECT.NET",
"affiliation": "N",
"address_1": "3501 Johnson Streeet",
"city": "Hollywood",
"state": "FL",
"country_code": "US",
"postal_code": "33021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.