Individual provider Active NPI

Lindsay Michelle Weiss, MD

  • Pediatrics Physician
  • Hollywood, FL
National Provider Identifier
1811315120
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME75684 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021
Phone
(954) 265-6301
Fax
(954) 985-1434
NPI assigned
Apr 3, 2014
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME75684 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021

Mailing address

1117 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4488
Phone (954) 454-5131

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-6662

Other identifiers 1

IdentifierTypeStateIssuer
104726100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lweiss217089@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190725002693 FL Practitioner - Pediatric MedicinePractitioner - Hospitalist 7517266638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME75684FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Hospitalist of South Florida PA Pediatrics CurrentSince Aug 1, 2019 Accepting new patients

Locations

1117 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 454-5131

1005 N 35th Ave
Hollywood, FL 33021
Phone (954) 265-5324

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: lweiss217089@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.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1811315120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094488",
            "telephone_number": "954-454-5131",
            "fax_number": "954-241-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-6301",
            "fax_number": "954-985-1434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISS",
        "first_name": "LINDSAY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME75684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104726100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lweiss217089@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St",
            "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

Verify at the official NPI Registry.