ETHAN DAVID WEISS
NPI 1245942481
Student in an Organized Health Care Education/Training Program in Columbia, MO

Active since December 19, 2022PECOS Enrolled
7412 OAKLEY DR, COLUMBIA, MO 65203(573) 705-8438 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Ethan David Weiss NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN DAVID WEISS (NPI 1245942481) is an individual student in an organized health care education/training program in Columbia, Missouri and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245942481
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN DAVID WEISS
Location Address7412 OAKLEY DRColumbia, MO 65203-9339
Mailing Address7412 Oakley DrColumbia, MO 65203-9339
Sole ProprietorNo
Enumeration DateDecember 19, 2022
NPPES CertifiedDecember 19, 2022
✔ NPI 1245942481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
7412 OAKLEY DR, Columbia, MO 65203

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan David Weiss is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Weiss's NPI number?

The NPI number for Ethan Weiss is 1245942481. It was assigned to this individual provider in the NPPES registry on December 19, 2022.

Where is Ethan Weiss located?

Ethan Weiss practices at 7412 Oakley Dr, Columbia, MO 65203. The listed phone number is (573) 705-8438.

What is Ethan Weiss's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ethan Weiss enrolled in Medicare?

Yes. Ethan Weiss is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Weiss was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.