Active NPI
Darren J. Weidenman, P.T., M.A.
- Physical Therapist
- Melville, NY
National Provider Identifier
1164539524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015673-1
- Practice address
- 713 Walt Whitman Rd
Suite B
Melville, NY 11747-2202 - Phone
- (631) 425-5900
- Fax
- (631) 424-9850
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 015673-1 | NY | Primary |
Addresses
Primary practice location
713 Walt Whitman Rd
Suite B
Melville, NY 11747-2202
Mailing address
713 Walt Whitman Rd
Suite B
Melville, NY 11747-2202
Phone (631) 425-5900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015673-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1164539524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 WALT WHITMAN RD",
"address_2": "SUITE B",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472202",
"telephone_number": "631-425-5900",
"fax_number": "631-424-9850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 WALT WHITMAN RD",
"address_2": "SUITE B",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472202",
"telephone_number": "631-425-5900",
"fax_number": "631-424-9850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIDENMAN",
"first_name": "DARREN",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "P.T., M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "015673-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.