Individual provider Active NPI

Brendan Weaver, OD

  • Optometrist
  • Birmingham, MI
National Provider Identifier
1902711609
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005981 Issued in MI
Practice address
800 S Adams Rd
Birmingham, MI 48009-7005
Phone
(248) 644-8060
NPI assigned
Aug 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005981 MI Primary

Addresses

Primary practice location

800 S Adams Rd
Birmingham, MI 48009-7005

Mailing address

PO Box 736510
Chicago, IL 60673-1408
Phone (636) 227-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1902711609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731408",
            "telephone_number": "636-227-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S ADAMS RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097005",
            "telephone_number": "248-644-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "BRENDAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.