Individual provider Active NPI

Michael Scott Weber, RPA-C

  • Medical Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1073695185
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
077391 Issued in NY
Practice address
2500 Nesconset Hwy
Building 7D
Stony Brook, NY 11790-2555
Phone
(631) 751-3322
Fax
(631) 751-3844
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 077391 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy
Building 7D
Stony Brook, NY 11790-2555

Mailing address

2500 Nesconset Hwy
Building 7D
Stony Brook, NY 11790-2555
Phone (631) 751-3322

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
I20140703000340 NY Practitioner - Physician Assistant 3476778549 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007739NYMDOptometrist
077391NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Feb 1, 2016 Accepting new patients
CHS Physician Partners, PC CurrentSince Feb 1, 2016 Accepting new patients

Locations

179 N Belle Mead Rd
East Setauket, NY 11733
Phone (631) 444-1970

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

2500 Nesconset Hwy
Bldg 7D
Stony Brook, NY 11790
Phone (631) 751-3322

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073695185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BUILDING 7D",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-3322",
            "fax_number": "631-751-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BUILDING 7D",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-3322",
            "fax_number": "631-751-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "077391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.