NPIMap

Individual provider Active NPI

Shana Esther Weiss, MD

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1932149945
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036101407 Issued in IL
Practice address
1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5227
Phone
(847) 573-9663
Fax
(847) 573-9662
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036101407 IL Primary

Addresses

Primary practice location

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5227

Mailing address

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5227
Phone (847) 573-9663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071203000226 IL Practitioner - Internal Medicine 9436248275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Primary Care S.C.Group PAC ID 6204925415, 8 clinicians

Practice addresses (Care Compare)

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5249
Phone (847) 573-9663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036101407ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Primary Care S.C. Internal Medicine CurrentSince Jun 1, 2005 Accepting new patients

Locations

1900 Hollister Dr
Ste 250
Libertyville, IL 60048
Phone (847) 549-0055

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1932149945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HOLLISTER DR",
            "address_2": "SUITE 250",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485227",
            "telephone_number": "847-573-9663",
            "fax_number": "847-573-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HOLLISTER DR",
            "address_2": "SUITE 250",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485227",
            "telephone_number": "847-573-9663",
            "fax_number": "847-573-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "SHANA",
        "middle_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036101407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.