Individual provider Active NPI

Paul S Weissman, MD

  • Gastroenterology Physician
  • Jersey City, NJ
National Provider Identifier
1063478469
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA43530 Issued in NJ
Practice address
377 Jersey Ave Ste 460
Jersey City, NJ 07302-4691
Phone
(201) 332-4110
Fax
(201) 332-4122
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MA43530 NJ Primary

Addresses

Primary practice location

377 Jersey Ave Ste 460
Jersey City, NJ 07302-4691

Mailing address

377 Jersey Ave Ste 460
Jersey City, NJ 07302-4691
Phone (201) 332-4110

Other identifiers 1

IdentifierTypeStateIssuer
1575309MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241025002018 NJ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0446443501

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA43530NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey City Medical Center Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Jersey City Medical Center Past Accepting new patients

Organizations & group practices 4

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1063478469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE STE 460",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024691",
            "telephone_number": "201-332-4110",
            "fax_number": "201-332-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE STE 460",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024691",
            "telephone_number": "201-332-4110",
            "fax_number": "201-332-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA43530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.