Jonathan Weaver, is a medicare enrolled "Nurse Practitioner - Primary Care" provider in Reno, Nevada. His current practice location is
343 Elm St Ste 401, Reno, Nevada. You can reach out to his office (for appointments etc.) via phone at
(775) 470-6651.
Jonathan Weaver is licensed to practice in Nevada (license number 885460) 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 1649521170.
Healthcare Provider's Profile
| Full Name | Jonathan Weaver |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Primary Care |
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| Location | 343 Elm St Ste 401, Reno, Nevada |
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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: 1649521170
- Provider Enumeration Date: 09/24/2012
- Last Update Date: 06/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 2769992551
- Enrollment ID: I20250610003709
Medical Identifiers
Medical identifiers for Jonathan Weaver such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1649521170 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | 885460 (Nevada) | Primary |
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. Jonathan Weaver allows following entities to bill medicare on his behalf.
| Entity Name | Revenge Medical Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942921200
PECOS PAC ID: 1052788254
Enrollment ID: O20221101000653 |
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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. Jonathan 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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Jonathan Weaver,
1400 E 9th St Unit 4,
Reno, NV 89512-2920
Ph: (775) 971-7353 | Jonathan Weaver,
343 Elm St Ste 401,
Reno, NV 89503-4541
Ph: (775) 470-6651 |
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