Active NPI
Mark Stephen Weisman Jr., MD
- Psychiatry Physician
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME112182
- Practice address
- 930 Alicia Rd
Lakeland, FL 33801-2104 - Phone
- (833) 769-3524
- NPI assigned
- May 24, 2010
- Last updated
- Sep 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 112182 | FL | |
| Psychiatry Physician | 2084P0800X | ME112182 | FL | Primary |
Addresses
Primary practice location
930 Alicia Rd
Lakeland, FL 33801-2104
Mailing address
1324 Lakeland Hills Blvd
Managed Care Dept
Lakeland, FL 33805
Other practice location 1
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- JC Edwards School of Medicine, Marshall University, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
115 S Missouri Ave
Suite 101
Lakeland, FL 33815-4601
Phone (863) 687-1222
1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1248
3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Phone (863) 603-6565
8570 Granite CT
Suite 101
Fort Myers, FL 33908-4102
Phone (239) 310-4646
Attn Managed Care
1324 Lakeland HLLS Blvd
Lakeland, FL 33805-4543
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112182 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Regional Health Systems, Inc. | Psychiatry | Current | Accepting new patients |
| Personal Recovery Network LLC | Psychiatry | Current | Accepting new patients |
Locations
8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646
1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132
3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565
930 Alicia Rd
Lakeland, FL 33801
Phone (863) 680-1950
260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450
10967 Lake Underhill Rd
Ste 113
Orlando, FL 32825
Phone (407) 537-9451
Interoperability endpoints
- fbh.markweisman@141363.advancedmd-direct.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Lakeland, FL
- NPI 1497748743
Psychiatry
-
dba LifeStance Health
- Psychiatry Physician
- Stockbridge, GA
- NPI 1881990869
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1932428406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 LAKELAND HILLS BLVD",
"address_2": "MANAGED CARE DEPT",
"city": "LAKELAND",
"state": "FL",
"postal_code": "33805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 ALICIA RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338012104",
"telephone_number": "833-769-3524"
}
],
"practiceLocations": [
{
"address_1": "1324 Lakeland Hills Blvd",
"address_purpose": "LOCATION",
"city": "Lakeland",
"state": "FL",
"postal_code": "338054543",
"country_code": "US",
"telephone_number": "863-687-1321",
"fax_number": "863-603-6534",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEISMAN",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-24",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "112182",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME112182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.