Jerry M Weida, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01020537 Issued in IN

Practice address

3005 Greenbush St
Lafayette, IN 47904-2435

Phone

(765) 447-3103

Fax

(765) 449-4782

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Family Practice

Education

Indiana University School of Medicine, 1966

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Home Care Home health agency, Lafayette, IN, CCN 157124
• Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109
• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Chiropractic Solutions of West Lafayette, LLC

  • Chiropractor
  • Lafayette, IN
  • NPI 1811337322
  NPD (past)

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

• Franciscan Health Lafayette

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1356435341
  Care Compare affiliation
• Franciscan Health Lafayette

  • Home Health Agency
  • Lafayette, IN
  • NPI 1619970134
  Care Compare affiliation
• Indiana University Health Arnett Inc

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1821083288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-447-3103",
            "fax_number": "765-449-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-447-3103",
            "fax_number": "765-449-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDA",
        "first_name": "JERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01020537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000375909",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230480A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alise Weeks, OTD, OTR/L
• Aubrey Lynne Weeks
• Kimbra Weesner
• Kyle A Wehmann, LSW
• Catherine Weida
• Caroline Weideman, LMHC
• Jonathan Doyle Weil
• Taylor Weishaar, CST
• Norbert Michael Welch, MD
• Valerie B Welch, MD

• Family Medicine Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.