Individual provider Active NPI

Kendra Leigh Weissberger

  • Family Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1124514708
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
640013 Issued in NY
Practice address
1983 Marcus Ave Ste C102
New Hyde Park, NY 11042-2006
Phone
(516) 876-4100
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 640013 NY Primary

Addresses

Primary practice location

1983 Marcus Ave Ste C102
New Hyde Park, NY 11042-2006

Mailing address

600 Community Dr Ste 400
Manhasset, NY 11030-3802
Phone (516) 876-4100

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
I20181206000683 NY Practitioner - Nurse Practitioner 8820332562 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
640013NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical Group P.C. CurrentSince Sep 29, 2018 Accepting new patients
Solaiman Chowdhury Medical Care PC CurrentSince Feb 9, 2024 Accepting new patients
North Shore-Lij Medical PC PastSince Sep 29, 2018 Accepting new patients

Locations

126 E Main St
Ste 1
East Islip, NY 11730
Phone (631) 277-8367

600 Community Dr
Ste 400
Manhasset, NY 11030
Phone (516) 600-1100

1983 Marcus Ave
Ste C102
New Hyde Park, NY 11042
Phone (516) 872-4100

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: kendraweissberger@nslijmedgr.allscriptsdirect.net

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1124514708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COMMUNITY DR STE 400",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303802",
            "telephone_number": "516-876-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 MARCUS AVE STE C102",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422006",
            "telephone_number": "516-876-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSBERGER",
        "first_name": "KENDRA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "640013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.