Organization Active NPI

Gerald Steven Weinstein

  • Gastroenterology Physician
  • Watertown, NY
National Provider Identifier
1003973421
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
144232 Issued in NY
Legal business name
GERALD STEVEN WEINSTEIN
Practice address
228 Sherman St
Watertown, NY 13601-3612
Phone
(315) 788-9849
Fax
(315) 788-9458
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Sue E Storino
Title
Office Manager
Phone
(315) 788-9849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 144232 NY Primary

Addresses

Primary practice location

228 Sherman St
Watertown, NY 13601-3612

Mailing address

228 Sherman St
Watertown, NY 13601-3612
Phone (315) 788-9849

Other identifiers 1

IdentifierTypeStateIssuer
00816353MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110309000151 NY Part B Supplier - Clinic/Group Practice 5597947754 Receives reassigned benefits from 1 practitioner
Practice locations: Watertown, NY

National Provider Directory

National Provider Directory

Locations

228 Sherman St
Watertown, NY 13601
Phone (315) 788-9849

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1003973421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013612",
            "telephone_number": "315-788-9849",
            "fax_number": "315-788-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013612",
            "telephone_number": "315-788-9849",
            "fax_number": "315-788-9458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD STEVEN WEINSTEIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "STORINO",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "315-788-9849"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "144232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00816353",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.