Individual provider Active NPI

Kathryn Louise Weber, NP

  • Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1922835172
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95030454 Issued in CA
Practice address
42362 Bob Hope Dr Ste 1
Rancho Mirage, CA 92270-4483
Phone
(760) 341-4839
Fax
(760) 340-3536
NPI assigned
Sep 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95030454 CA Primary

Addresses

Primary practice location

42362 Bob Hope Dr Ste 1
Rancho Mirage, CA 92270-4483

Mailing address

3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071
Phone (951) 687-3400

Other practice location 1

401 E Highland Ave Ste 551
San Bernardino, CA 92404-3840
Phone (909) 882-9150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241015000556 CA Practitioner - Nurse Practitioner 9739611856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates Medical Group IncGroup PAC ID 5092604447, 64 clinicians

Practice addresses (Care Compare)

42362 Bob Hope Dr
Suite 1
Rancho Mirage, CA 92270-4483
Phone (760) 341-4839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95030454CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Medical Group Inc CurrentSince Sep 9, 2024 Accepting new patients

Locations

42362 Bob Hope Dr
Ste 1
Rancho Mirage, CA 92270
Phone (760) 341-4839

3660 Park Sierra Dr
Ste 203
Riverside, CA 92505
Phone (951) 687-3400

3660 Park Sierra Dr
Ste 208
Riverside, CA 92505
Phone (951) 687-2800

401 E Highland Ave
Ste 551
Sn Bernrdno, CA 92404
Phone (909) 882-1759

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kathryn.weber.1@19859.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1922835172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42362 BOB HOPE DR STE 1",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704483",
            "telephone_number": "760-341-4839",
            "fax_number": "760-340-3536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Highland Ave Ste 551",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924043840",
            "country_code": "US",
            "telephone_number": "909-882-9150",
            "fax_number": "909-883-8972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KATHRYN",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95030454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.