Individual provider Active NPI

Thomas Martin Weiser, M.D.

  • Family Medicine Physician
  • Warm Springs, OR
National Provider Identifier
1962687707
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AG1377 Issued in CA
Practice address
1270 Kotnum Road
Warm Springs, OR 97761-1209
Phone
(541) 553-1196
Fax
(541) 553-2135
NPI assigned
Dec 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AG1377 CA Primary

Addresses

Primary practice location

1270 Kotnum Road
Warm Springs, OR 97761-1209

Mailing address

PO Box 1209
Warm Springs, OR 97761-1209
Phone (541) 553-1196

Other identifiers 1

IdentifierTypeStateIssuer
273855MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000176 TX Practitioner - Family Practice 5597838045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chemawa Indian Health Center DHHS IHS Western Oregon Serv UnitGroup PAC ID 1759307796, 11 clinicians

Practice addresses (Care Compare)

3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone (503) 304-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG1377CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chemawa Indian Health Center DHHS IHS Western Oregon Serv Unit CurrentSince Jan 28, 2011 Accepting new patients
DHHS IHS Phoenix Area Past Accepting new patients

Locations

3750 Chemawa Rd NE
Salem, OR 97305
Phone (503) 304-7600

Organizations & group practices 3

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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1962687707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196",
            "fax_number": "541-553-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOTNUM ROAD",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196",
            "fax_number": "541-553-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISER",
        "first_name": "THOMAS",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "AG1377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273855",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warm Springs, OR

Sources for this page

Verify at the official NPI Registry.