DR. JONATHAN WADE WEISS (NPI# 1881779700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881779700 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN WADE WEISS |
| Credential | M.D. |
| Practice Address |
620 W Edison Rd Suite 110 Mishawaka IN 46545-2784 |
| Practice Telephone | 5742581100 |
| Practice Fax Number | 5742581101 |
| Mailing Telephone | 5742581100 |
| Mailing Fax Number | 5742581101 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
01065200A | IN | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
47571-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200949650 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174188817 | Jonathan Michael Weiss | Student in an Organized Health Care Education/Training Program | Upmc St. Margaret Family Medicine Residency, 815 Freeport Road, Pittsburgh, PA 15215 | 2019-05-08 |
| 1720509953 | Jonathan Weiss | Psychologist | 2920 Broadway Fl 8, New York, NY 10027-7164 | 2017-06-28 |
| 1528119385 | Jonathan Samuel Weiss | Psychiatry & Neurology | 555 Turnpike Street, Suite 53, North Andover, MA 01845 | 2007-01-16 |
| 1851474415 | Jonathan Victor Weiss | Social Worker | 102 Proctors Cir, Williamsburg, VA 23185-1419 | 2006-10-24 |
| 1700873742 | Jonathan H Weiss | Anesthesiology | 111 S 11th St Ste G8490, Philadelphia, PA 19107 | 2005-10-04 |
| 1295229458 | Jonathan Weiss | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2018-06-20 |
| 1225487689 | Jonathan David Weiss | Dentist | 255 Sw Main Blvd, Lake City, FL 32025-7050 | 2016-06-07 |
| 1801291299 | Jonathan Weiss | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2014-10-28 |
| 1376966366 | Jonathan Weiss Jr. | Counselor | 102 Pilling St, Brooklyn, NY 11207-1610 | 2014-01-27 |
| 1568747657 | Jonathan Weiss | Physical Therapist | 7 Carnegie Plz, Cherry Hill, NJ 08003-1000 | 2011-10-20 |
| Street Address |
620 W EDISON RD SUITE 110 |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-2784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557815 | Radiology, Inc | Radiology | 620 W Edison Rd, Suite 110, Mishawaka, IN 46545-2784 | 2005-09-01 |
| 1437502721 | Leslie M Peters | Nurse Practitioner | 620 W Edison Rd, Suite 110, Mishawaka, IN 46545-2784 | 2016-07-21 |
| 1740520717 | Sarah Suzanne Bortone | Nurse Practitioner | 620 W Edison Rd, Suite 118, Mishawaka, IN 46545-2784 | 2013-02-27 |
| 1720326614 | Dawn Elizabeth Lanser | Registered Nurse | 620 W Edison Rd, Suite 140, Mishawaka, IN 46545-2784 | 2013-01-28 |
| 1740506229 | Sridevi Kanuri | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2010-04-09 |
| 1851548127 | Nazar Golewale | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-08-19 |
| 1013163526 | Benjamin Jon Moreno | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-08-15 |
| 1326204850 | Thomas K Rhee | Internal Medicine | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-08-04 |
| 1669637153 | Thomas Gast | Radiology | 620 W Edison Rd, Suite 110, Mishawaka, IN 46545-2784 | 2008-07-23 |
| 1992967293 | Stephen Joowhan Kim | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982656963 | Terrence D. Wilkin | Radiology | 611 E Douglas Rd Ste 200, Mishawaka, IN 46545-1465 | 2006-05-17 |
| 1245289446 | Charles W Bower | Radiology | 620 W Edison Rd Ste 110, Mishawaka, IN 46545-2784 | 2006-05-08 |
| 1205891140 | Mark S Borenstein | Radiology | 250 E Day Rd Ste 300, Mishawaka, IN 46545-3471 | 2006-04-20 |
| 1467870196 | Thomas Lowe | Radiology | 620 W Edison Rd Ste 110, Mishawaka, IN 46545-2784 | 2014-03-31 |
| 1851548127 | Nazar Golewale | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-08-19 |
| 1013163526 | Benjamin Jon Moreno | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-08-15 |
| 1669637153 | Thomas Gast | Radiology | 620 W Edison Rd, Suite 110, Mishawaka, IN 46545-2784 | 2008-07-23 |
| 1992967293 | Stephen Joowhan Kim | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-06-27 |
| 1346401395 | Justin Jeremiah Lightburn | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2008-06-23 |
| 1861694556 | Alexander Marcus Tawadros | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2007-06-04 |
| Find all providers in MISHAWAKA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.