NPIMap

Individual provider Active NPI

Michael Dennis Weaver, D.O., M.S.

  • Physical Medicine & Rehabilitation Physician
  • Omaha, NE
National Provider Identifier
1851432819
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1593 Issued in NE
Practice address
Emile 42ND St
Omaha, NE 68198-0001
Phone
(402) 559-8600
Fax
(402) 559-8940
NPI assigned
Feb 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 03255 KY
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 03255 KY
Physical Medicine & Rehabilitation Physician 208100000X 1593 NE Primary

Addresses

Primary practice location

Emile 42ND St
Omaha, NE 68198-0001

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other identifiers 1

IdentifierTypeStateIssuer
7100130950MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105000809 NE Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 2961674932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madonna Rehabilitation HospitalGroup PAC ID 0446164081, 92 clinicians
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

5401 S St
Lincoln, NE 68506-2150
Phone (402) 489-7102

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
03255KYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madonna Rehabilitation Hospital Physical Medicine & Rehabilitation CurrentSince Mar 1, 2017 Accepting new patients
Unmc Physicians CurrentSince Dec 5, 2016 Accepting new patients
Madonna Rehabilitation Hospital Past Accepting new patients
Eye Surgical Associates, LLC Past Accepting new patients

Locations

5401 South St
Lincoln, NE 68506
Phone (402) 413-3000

5445 South St
Lincoln, NE 68506
Phone (402) 489-8838

17500 Burke St
Omaha, NE 68118
Phone (402) 401-3000

110 N 175th St
Ste 2000
Omaha, NE 68118
Phone (402) 596-4411

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1851432819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMILE 42ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-8600",
            "fax_number": "402-559-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "MICHAEL",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.O., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "03255",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KY",
            "license": "03255",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NE",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100130950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.