Active NPI
Brian J Weiss, DPM
- Podiatrist
- Lyndhurst, OH
National Provider Identifier
1891781019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 36-00-2169-W
- Practice address
- 5035 Mayfield Rd
Suite #215
Lyndhurst, OH 44124-2688 - Phone
- (440) 382-8070
- Fax
- (216) 382-6767
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 36-00-2169-W | OH | Primary |
Addresses
Primary practice location
5035 Mayfield Rd
Suite #215
Lyndhurst, OH 44124-2688
Mailing address
5035 Mayfield Rd
Suite #215
Lyndhurst, OH 44124-2688
Phone (440) 382-8070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0678306 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2169 | OH | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354060800000",
"number": "1891781019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5035 MAYFIELD RD",
"address_2": "SUITE #215",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242688",
"telephone_number": "440-382-8070",
"fax_number": "216-382-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5035 MAYFIELD RD",
"address_2": "SUITE #215",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242688",
"telephone_number": "440-382-8070",
"fax_number": "216-382-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "BRIAN",
"middle_name": "J",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2012-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OH",
"license": "36-00-2169-W",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0678306",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lyndhurst, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.