Individual provider Active NPI

Michael Jon Weiss

  • Physical Therapist
  • Folsom, CA
National Provider Identifier
1831247303
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 14220 Issued in CA
Practice address
2575 E Bidwell St Ste 160
Folsom, CA 95630-6446
Phone
(916) 932-1210
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 14220 CA Primary

Addresses

Primary practice location

2575 E Bidwell St Ste 160
Folsom, CA 95630-6446

Mailing address

2575 E Bidwell St Ste 160
Folsom, CA 95630-6446
Phone (916) 932-1210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121212000395 CA Practitioner - Physical Therapist in Private Practice 2567614803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT 14220CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Spine & Physical Therapy Inc. CurrentSince Dec 1, 2012 Accepting new patients
Sacramento Spine & Physical Therapy Inc. Physical Therapist CurrentSince Dec 1, 2012 Accepting new patients

Locations

700 Oak Avenue Pkwy
Ste B
Folsom, CA 95630
Phone (916) 932-1210

2575 E Bidwell St
Ste 160
Folsom, CA 95630
Phone (916) 817-3730

1650 Lead Hill Blvd
Ste 300
Roseville, CA 95661
Phone (916) 677-1210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1831247303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 E BIDWELL ST STE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306446",
            "telephone_number": "916-932-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E BIDWELL ST STE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306446",
            "telephone_number": "916-932-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 14220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.