Individual provider Active NPI

Clifford Weingarten

  • Internal Medicine Physician
  • Melville, NY
National Provider Identifier
1104826585
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
083595 Issued in NY
Practice address
2 Leefield Gate
Melville, NY 11747-1612
Phone
(631) 427-7651
Fax
(631) 549-1526
NPI assigned
Jul 27, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 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 083595 NY Primary

Addresses

Primary practice location

2 Leefield Gate
Melville, NY 11747-1612

Mailing address

2 Leefield Gate
Melville, NY 11747-1612
Phone (631) 427-7651

Other identifiers 1

IdentifierTypeStateIssuer
00623318MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000685 NY Practitioner - Internal Medicine 4789872920 Practice locations: Huntington Station, NY

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PJS Medical Diagnostic PLLC Internal Medicine Past Accepting new patients
Mendelsohn Medical, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1104826585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LEEFIELD GATE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471612",
            "telephone_number": "631-427-7651",
            "fax_number": "631-549-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LEEFIELD GATE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471612",
            "telephone_number": "631-427-7651",
            "fax_number": "631-549-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINGARTEN",
        "first_name": "CLIFFORD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2010-09-29",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "083595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00623318",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.