John Joseph Weaver, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Ketchikan, Alaska. His current practice location is
3100 Tongass Ave, Ketchikan, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 228-4644.
John Joseph Weaver is licensed to practice in Alaska (license number 219179) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164928685.
Physician's Profile
| Full Name | John Joseph Weaver |
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| Gender | Male |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 3100 Tongass Ave, Ketchikan, Alaska |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164928685
- Provider Enumeration Date: 04/03/2018
- Last Update Date: 05/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 4385978592
- Enrollment ID: I20240522004135
Medical Identifiers
Medical identifiers for John Joseph Weaver such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1164928685 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0202X | Radiology - Diagnostic Radiology | 219179 (Alaska) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD61549873 (Washington) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John Joseph Weaver allows following entities to bill medicare on his behalf.
| Entity Name | Northwest Radiologists Inc Ps |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013907955
PECOS PAC ID: 1456248368
Enrollment ID: O20040303001109 |
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| Entity Name | Mt Baker Imaging Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295725133
PECOS PAC ID: 7113963802
Enrollment ID: O20050705000191 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John Joseph Weaver is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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John Joseph Weaver, MD
4n199 Fox Mill Blvd,
Saint Charles, IL 60175-7770
Ph: (630) 479-9503 | John Joseph Weaver, MD
3100 Tongass Ave,
Ketchikan, AK 99901-5746
Ph: (907) 228-4644 |
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