Organization Active NPI

Joseph S. Weiner, M.D., P.C.

  • Psychosomatic Medicine Physician
  • Great Neck, NY
National Provider Identifier
1063704229
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
177126 Issued in NY
Legal business name
JOSEPH S. WEINER, M.D., P.C.
Practice address
1010 Northern Blvd
Suite 208
Great Neck, NY 11021-5317
Phone
(516) 336-2585
Fax
(516) 336-2584
NPI assigned
May 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Joseph S. Weiner, M.D.NPI 1023168929
Title
President
Phone
(516) 336-2585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0015X 177126 NY Primary

Addresses

Primary practice location

1010 Northern Blvd
Suite 208
Great Neck, NY 11021-5317

Mailing address

1010 Northern Blvd
Suite 208
Great Neck, NY 11021-5317
Phone (516) 336-2585

Other identifiers 1

IdentifierTypeStateIssuer
01265067MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110520000645 NY Part B Supplier - Clinic/Group Practice 2668658931 Receives reassigned benefits from 1 practitioner
Practice locations: Port Washington, NY

National Provider Directory

National Provider Directory

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": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1063704229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD",
            "address_2": "SUITE 208",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215317",
            "telephone_number": "516-336-2585",
            "fax_number": "516-336-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD",
            "address_2": "SUITE 208",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215317",
            "telephone_number": "516-336-2585",
            "fax_number": "516-336-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH S. WEINER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-336-2585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NY",
            "license": "177126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01265067",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.