Organization Active NPI

Steven M. Weissman, MD PLLC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1093068611
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
STEVEN M. WEISSMAN, MD PLLC
Practice address
9413 Flatlands Ave
Suite 102 East
Brooklyn, NY 11236-3726
Phone
(718) 853-7546
Fax
(718) 682-0146
NPI assigned
Oct 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Steven M Weissman, M.D.NPI 1164408282
Title
Provider
Phone
(718) 853-7546

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
Pediatric Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NP0225X
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

9413 Flatlands Ave
Suite 102 East
Brooklyn, NY 11236-3726

Mailing address

4 Weston PL
Lawrence, NY 11559-1525
Phone (718) 853-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160613000145 NJ Part B Supplier - Clinic/Group Practice 6901051135 Receives reassigned benefits from 6 practitioners
Practice locations: Jackson, NJ; Toms River, NJ
O20170308002395 NY Part B Supplier - Clinic/Group Practice 6901051135 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2903 1st Ave
Ste 0
Lake Charles, LA 70601

27 S Cooks Bridge Rd
Ste 2-14
Jackson, NJ 08527
Phone (732) 876-3376

277 Route 70
Ste 104
Toms River, NJ 08755

277 Route 70
Ste 1
Toms River, NJ 08755

277 Route 70
Ste 101
Toms River, NJ 08755

277 Route 70
Ste 101104
Toms River, NJ 08755
Phone (732) 876-3376

9413 Flatlands Ave
Ste 102
Brooklyn, NY 11236
Phone (718) 345-2299

586 Dekalb Ave
Brooklyn, NY 11205

12 Bayview Ave
Unit 222
Lawrence, NY 11559

65 Fort Washington Ave
Apt 1B
New York, NY 10032
Phone (718) 872-9400

Practitioners & affiliated clinicians

Practitioners 10

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": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1093068611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WESTON PL",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591525",
            "telephone_number": "718-853-7546",
            "fax_number": "718-682-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9413 FLATLANDS AVE",
            "address_2": "SUITE 102 EAST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363726",
            "telephone_number": "718-853-7546",
            "fax_number": "718-682-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN M. WEISSMAN, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "WEISSMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "718-853-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.