Active NPI
Joel Marvin Weissman, M.D.
- Urology Physician
- Philadelphia, PA
National Provider Identifier
1922017763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 014154E
- Practice address
- 7604 Central Ave
Suite 104
Philadelphia, PA 19111-2433 - Phone
- (215) 745-4130
- Fax
- (215) 745-9666
- NPI assigned
- Aug 7, 2006
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 014154E | PA | Primary |
Addresses
Primary practice location
7604 Central Ave
Suite 104
Philadelphia, PA 19111-2433
Mailing address
7604 Central Ave
Suite 104
Philadelphia, PA 19111-2433
Phone (215) 745-4130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0674929 | Medicaid | PA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014154E | PA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urologic Consultants of Southeastern Pennsylvania LLP | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Bala Cynwyd, PA
- NPI 1477955375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268265600000",
"number": "1922017763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7604 CENTRAL AVE",
"address_2": "SUITE 104",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112433",
"telephone_number": "215-745-4130",
"fax_number": "215-745-9666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7604 CENTRAL AVE",
"address_2": "SUITE 104",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112433",
"telephone_number": "215-745-4130",
"fax_number": "215-745-9666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISSMAN",
"first_name": "JOEL",
"middle_name": "MARVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2010-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "014154E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0674929",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.