Individual provider Active NPI

Jeffrey Weissman, O.D.

  • Optometrist
  • Henrietta, NY
National Provider Identifier
1003963190
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005155-1 Issued in NY
Practice address
2824 E Henrietta Rd
Henrietta, NY 14467-9322
Phone
(585) 334-7262
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005155-1 NY Primary

Addresses

Primary practice location

2824 E Henrietta Rd
Henrietta, NY 14467-9322

Mailing address

2824 E Henrietta Rd
Henrietta, NY 14467-9322
Phone (585) 334-7262

Other identifiers 7

IdentifierTypeStateIssuer
5833511OtherNYAETNA
P010005155OtherNYEXCELLUS
P010005155OtherNYVIA HEALTH
P010005155OtherNYBLUE CROSS
100173CSOtherNYPREFERRED CARE
P010005155MedicaidNY
P010005155OtherNYBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000805 NY Practitioner - Optometry 1456382126 Reassigns benefits to 1 organization
Practice locations: Henrietta, NY; Webster, NY; Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2824 E Henrietta Rd
Henrietta, NY 14467-9322
Phone (585) 334-7262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005155-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Sep 4, 2002 Accepting new patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital CurrentSince Sep 4, 2002 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: jweissman83524@direct.rochesterregional.org

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1003963190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 E HENRIETTA RD",
            "city": "HENRIETTA",
            "state": "NY",
            "postal_code": "144679322",
            "telephone_number": "585-334-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 E HENRIETTA RD",
            "city": "HENRIETTA",
            "state": "NY",
            "postal_code": "144679322",
            "telephone_number": "585-334-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "JEFFREY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005155-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5833511",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "P010005155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIA HEALTH",
            "identifier": "P010005155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P010005155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "100173CS",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P010005155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010005155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrietta, NY

Sources for this page

Verify at the official NPI Registry.