Individual provider Active NPI

Susan E Weiss, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1073680690
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331108 Issued in NY
Practice address
760 Broadway
Brooklyn, NY 11206-5317
Phone
(718) 963-7933
Fax
(718) 630-3110
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331108 NY Primary

Addresses

Primary practice location

760 Broadway
Brooklyn, NY 11206-5317

Mailing address

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-7933

Other identifiers 1

IdentifierTypeStateIssuer
01854282MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address weisss12@nychhc.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608001184 NY Practitioner - Nurse Practitioner 5890917314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331108NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Feb 6, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 6, 2021 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

100 N Portland Ave
Brooklyn, NY 11205
Phone (718) 260-7500

760 Broadway
Brooklyn, NY 11206
Phone (718) 963-5807

50 Water St
Fl 3
New York, NY 10004

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

227 Madison St
New York, NY 10002
Phone (212) 238-7000

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1073680690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-7933",
            "fax_number": "212-271-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-7933",
            "fax_number": "718-630-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01854282",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "weisss12@nychhc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "760 Broadway",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112065317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.