Individual provider Active NPI

Robert J Weiss, MD

  • Surgery Physician
  • Liverpool, NY
National Provider Identifier
1053306654
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
173015 Issued in NY
Practice address
5100 W Taft Rd
Suite 2Q
Liverpool, NY 13088-3807
Phone
(315) 452-2727
Fax
(315) 452-2729
NPI assigned
Sep 20, 2005
Last updated
Aug 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 173015 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 2Q
Liverpool, NY 13088-3807

Mailing address

5100 W Taft Rd
Suite 2Q
Liverpool, NY 13088-3807
Phone (315) 452-2727

Other identifiers 1

IdentifierTypeStateIssuer
01551500MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060719000120 NY Practitioner - General Surgery 4981617891 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 452-2727

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)30
Melanoma (skin cancer) excision1-10
Removal of tissue23
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
173015NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Wound Physician Services, PLLC CurrentSince Feb 3, 2017 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Apr 15, 2021 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Apr 15, 2021 Accepting new patients
Robert J Weiss MD PC Surgery CurrentSince Dec 24, 1996 Accepting new patients
St Josephs Hospital Health Center Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

28 Kellogg Rd
Cortland, NY 13045
Phone (607) 753-6060

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

5100 W Taft Rd
Ste 2Q
Liverpool, NY 13088
Phone (315) 457-7290

5100 W Taft Rd
Ste 2R
Liverpool, NY 13088
Phone (315) 452-2055

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: drrweiss@surgicalpractice.medentdirect.com
  • Direct secure messaging: robertweiss@drjwm.allscriptsdirect.net
  • Direct secure messaging: rweiss162443@direct-guthrie.org
  • Direct secure messaging: rweiss2387025@direct.trinity-health.org
  • Direct secure messaging: weissr@hiemail.healtheconnections.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1053306654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2Q",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2727",
            "fax_number": "315-452-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2Q",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2727",
            "fax_number": "315-452-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "173015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01551500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.