Individual provider Active NPI

Laurence M Weinberg, M.D.

  • Gastroenterology Physician
  • Santa Fe, NM
National Provider Identifier
1154380806
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD20090086 Issued in NM
Practice address
1691 Galisteo St
Suite C
Santa Fe, NM 87505-4780
Phone
(505) 983-5631
Fax
(505) 982-5605
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD20090086 NM Primary

Addresses

Primary practice location

1691 Galisteo St
Suite C
Santa Fe, NM 87505-4780

Mailing address

1691 Galisteo Street
Suite C
Santa Fe, NM 87505
Phone (505) 983-5631

Other identifiers 1

IdentifierTypeStateIssuer
0010652890003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20120430000726 NM Practitioner - Gastroenterology 9133192834 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20090086NMMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NNM Gastroenterology Associates PA CurrentSince Feb 1, 2012 Accepting new patients
West Chester Gi Associates PC Gastroenterology Past Accepting new patients
West Chester Gi Associates, PC Gastroenterology Past Accepting new patients

Locations

1691 Galisteo St
Ste C
Santa Fe, NM 87505
Phone (505) 983-5631

Organizations & group practices 3

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1154380806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO STREET",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERG",
        "first_name": "LAURENCE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD20090086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010652890003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.