NPIMap

Individual provider Active NPI

Edward J Weiner, MD

  • Internal Medicine Physician
  • Great Barrington, MA
National Provider Identifier
1083672752
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151432 Issued in MA
Practice address
116 West Ave
Fairview Internal Medicine
Great Barrington, MA 01230
Phone
(413) 528-8647
Fax
(413) 528-8290
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151432 MA Primary

Addresses

Primary practice location

116 West Ave
Fairview Internal Medicine
Great Barrington, MA 01230

Mailing address

725 North St
Pittsfield, MA 01201-4109
Phone (413) 477-2752

Other identifiers 1

IdentifierTypeStateIssuer
3156575MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050317000820 MA Practitioner - Internal Medicine 7214982644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview HospitalGroup PAC ID 1254240773, 56 clinicians

Practice addresses (Care Compare)

780 Main St
Great Barrington, MA 01230-2148
Phone (413) 528-8290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151432MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Feb 1, 2020 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Sep 1, 1996 Accepting new patients
Fairview Hospital CurrentSince Sep 1, 1996 Accepting new patients
Fairview Hospital Current Accepting new patients
Fairview Hospital CurrentSince Feb 1, 2020 Accepting new patients

Locations

29 Lewis Ave
Gt Barrington, MA 01230
Phone (413) 528-0790

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: edwardweiner@fvh.medalliesdirect.net

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1083672752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-477-2752",
            "fax_number": "413-496-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WEST AVE",
            "address_2": "FAIRVIEW INTERNAL MEDICINE",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "01230",
            "telephone_number": "413-528-8647",
            "fax_number": "413-528-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3156575",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Barrington, MA

Sources for this page

Verify at the official NPI Registry.