Blake Alexander Weis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036150541 Issued in IL

Practice address

611 W Park St
Urbana, IL 61801

Phone

(217) 383-3311

NPI assigned

Jun 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Northeastern Ohio University College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, 142 clinicians

Richland Memorial Hospital IncGroup PAC ID 3870565732, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• Carle Richland Memorial Hospital Hospital, Olney, IL, CCN 141355
• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Graham Hospital Association Hospital, Canton, IL, CCN 141356
• Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bweismd289490@carlehiedirect.net

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.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group NPD
• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment Care Compare group NPD
• Hoopeston Community Memorial Hospital

  dba Hoopeston Physician Group

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014
  Medicare reassignment Care Compare group NPD
• Richland Memorial Hospital, Inc

  dba Carle Richland Memorial Hospital

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Medicare reassignment Care Compare group NPD
• Christie Clinic, PLLC

  • Internal Medicine Physician
  • Champaign, IL
  • NPI 1871523829
  Medicare reassignment NPD
• Kirby Medical Center

  • Family Medicine Physician
  • Monticello, IL
  • NPI 1386635373
  Medicare reassignment NPD
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847
  Medicare reassignment
• Graham Hospital Association

  dba GMG South - Primary & Convenient Care Clinic

  • Family Medicine Physician
  • Galesburg, IL
  • NPI 1346093937
  NPD
• Graham Hospital Association

  dba Knox & Fulton County Wound and Hyperbaric Medicine

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  NPD
• Hoopeston Community Memorial Hospital

  dba Charlotte Ann Russell Medical Center

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  dba Hoopeston Community Ambulance

  • Ambulance
  • Hoopeston, IL
  • NPI 1164594594

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Care Compare affiliation
• Richland Memorial Hospital, Inc

  dba Carle Richland Memorial Hospital

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1801236617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-902-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York Street",
            "address_2": "Department of Neuroradiology",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06510",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 S Woods Mill Rd",
            "address_2": "Dept of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630173417",
            "country_code": "US",
            "telephone_number": "314-205-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIS",
        "first_name": "BLAKE",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036150541",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013018930",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014034042",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2014034042",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "61241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Webber, OT
• Emily A Weber, APRN, CNP
• Stephanie K Weber, MD
• Jossemia Webster, CCC-SLP/L
• Teri D Weir, PA
• Jon S Weisbaum, DO
• J. Timothy Weitekamp, RPH
• William Benjamin Welch, MD
• Robert E Welke, M.D.
• Robert (Bruce) B Wellman, M.D.

• Diagnostic Radiology Physician in Urbana, IL
• Providers in Urbana, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.
• 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.