Ekaterina Sue Weaver, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28243181A Issued in IN

Practice address

60101 Bodnar Blvd Ste 100B
Mishawaka, IN 46544-9340

Phone

(574) 335-8500

Fax

(574) 335-0794

NPI assigned

Dec 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

RP Care LLCGroup PAC ID 9234424813, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
• Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300
• Saint Joseph Regional Medical Center - Plymouth Hospital, Plymouth, IN, CCN 150076

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eweaver1781169@direct.trinity-health.org

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.

• RP Care LLC

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1134570104
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD

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

• Community Hospital of Bremen, Inc

  • Critical Access Hospital
  • Bremen, IN
  • NPI 1568417004
  Care Compare affiliation
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • General Acute Care Hospital
  • Plymouth, IN
  • NPI 1174571129
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1861269110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60101 BODNAR BLVD STE 100B",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449340",
            "telephone_number": "574-335-8500",
            "fax_number": "574-335-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "EKATERINA",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28243181A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tosha E Watkins, MNT
• Alan H Wax, PHD HSPP
• Chana Wax, CCC-SLP
• Rozi P Wax, LMHC
• Judith A. Weaver-Yoder, CNM
• Leroy D Weaver Jr., MD
• Nicola Weaver
• Andrew Webb
• Dana Lorraine Webb, FNP
• Justin Webb

• Family Nurse Practitioner in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.