Adam Weaver, P.A.-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA60749442 Issued in WA

Practice address

1330 Rockefeller Ave Ste 400
Everett, WA 98201-1676

Phone

(425) 261-4950

NPI assigned

Sep 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart Surgeons of Kansas City IncGroup PAC ID 5193878072, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
• Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aweaver798176@wm.providencedirect.org
• Direct secure messaging: aweaver358724@direct.saint-lukes.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.

• Heart Surgeons of Kansas City, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kansas City, MO
  • NPI 1164665600
  Medicare reassignment Care Compare group
• Saint Luke'S Physician Group Inc

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1093263717
  NPD (past)

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

• Saint Lukes East Hospital

  • General Acute Care Hospital
  • Lees Summit, MO
  • NPI 1053353490
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1891002606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE STE 400",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011676",
            "telephone_number": "425-261-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "ADAM",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01515",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60749442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "068002153",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200852150A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aweaver798176@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1330 Rockefeller Ave Ste 400",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stefanie Watt
• We-Mo PLLC
• David Robert Weadon
• Richard Floyd Wear
• Aaron Palmer Weaver
• Dale Weaver
• Kelly B Weaver, MD
• Angela Lynn Webb, ADN, RN
• Dy'Man Webb
• Jessica Susan Webb

• Surgical Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.