Individual provider Active NPI

Jonathan P Weaver, CRNA

  • Certified Registered Nurse Anesthetist
  • Wyomissing, PA
National Provider Identifier
1790989218
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
78052 Issued in PA
Practice address
1 Granite Point Dr Ste 200
Wyomissing, PA 19610-1992
Phone
(610) 685-9204
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 78052 PA Primary

Addresses

Primary practice location

1 Granite Point Dr Ste 200
Wyomissing, PA 19610-1992

Mailing address

PO Box 6738
Wyomissing, PA 19610-0738
Phone (610) 988-6060

Other identifiers 9

IdentifierTypeStateIssuer
108434OtherPAGEISINGER
11803086OtherPACAQH
1027812500001MedicaidPA
1580156OtherPAGATEWAY
1982255OtherPAHIGHMARK
1982255OtherPAFIRST PRIORITY
2858756000OtherPAIBC
50069828OtherPACAPITAL ADVANTAGE
9317982OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070920000497 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416041546 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania Anesthesia Coalition LLCGroup PAC ID 4284040189, 14 clinicians

Practice addresses (Care Compare)

2630 Westview Dr
Reading, PA 19610-1130
Phone (610) 898-1515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
78052PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sda Consultants PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 1, 2024 Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jan 1, 2020 Accepting new patients
Northeastern Anesthesia Physicians P.C. CurrentSince Oct 10, 2023 Accepting new patients
Bryn Mawr Medical Specialists Association CurrentSince Jun 29, 2021 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Midatlantic Endoscopy LLC Current Accepting new patients
GSC Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2021 Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jan 1, 2020 Accepting new patients
Rgal Anesthesia Services LLC CurrentSince Jan 7, 2021 Accepting new patients
Pennsylvania Anesthesia Coalition LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 4, 2020 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 1, 2024 Accepting new patients

Locations (25 of 27)

400 10th St E
Waconia, MN 55387

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1245 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 402-9080

24 S 18th St
Allentown, PA 18104
Phone (610) 628-8372

2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

825 Old Lancaster Rd
Ste 330
Bryn Mawr, PA 19010
Phone (484) 380-2880

625 Clark Ave
Ste 17B
King of Prussia, PA 19406
Phone (215) 654-1544

700 S Henderson Rd
Ste 335
Kng of Prussa, PA 19406
Phone (610) 337-2828

2104 Harrisburg Pike
Ste 300
Lancaster, PA 17601
Phone (717) 544-3400

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

1000 N Broad St
Ste 2
Lansdale, PA 19446
Phone (215) 412-9115

325 Central Ave
Fl 2
Malvern, PA 19355

2000 Grant Ave
Ste 101
Philadelphia, PA 19115
Phone (215) 990-6002

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

330 Main St
Scranton, PA 18519
Phone (570) 330-5000

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

100 E Lancaster Ave
Ste 158
Wynnewood, PA 19096
Phone (484) 206-5800

1011 Reed Ave
Ste 600
Wyomissing, PA 19610
Phone (610) 288-3229

1011 Reed Ave
Ste 300
Wyomissing, PA 19610
Phone (610) 374-4401

2630 Westview Dr
Wyomissing, PA 19610
Phone (610) 376-1981

1 Granite Point Dr
Ste 200
Wyomissing, PA 19610
Phone (610) 685-9204

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1790989218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6738",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196100738",
            "telephone_number": "610-988-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR STE 200",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101992",
            "telephone_number": "610-685-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "78052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "108434",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11803086",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027812500001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1580156",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1982255",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "1982255",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2858756000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "50069828",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9317982",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.