Individual provider Active NPI

Freddie Weinstein, M.D.

  • Psychiatry Physician
  • Santa Cruz, CA
National Provider Identifier
1205980729
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G073362 Issued in CA
Practice address
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone
(831) 462-7507
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G073362 CA Primary

Addresses

Primary practice location

1555 Soquel Dr
Santa Cruz, CA 95065-1705

Mailing address

1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone (831) 462-7507

Other identifiers 4

IdentifierTypeStateIssuer
ZZZ92069ZOtherCAMEDICARE GROUP PTAN#
ZZZ91892ZOtherCAMEDICARE GROUP PTAN#
ZZZ91891ZOtherCAMEDICARE GROUP PTAN#
00G733620MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080725000628 CA Practitioner - Psychiatry 8820161649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G073362CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Jul 1, 2019 Accepting new patients
Telecare Corporation CurrentSince Jul 1, 2019 Accepting new patients
Telecare Corporation Current Accepting new patients
County of Santa Cruz Past Accepting new patients
Dignity Health Past Accepting new patients
Puentes Al Sur Past Accepting new patients
County of Santa Cruz Past Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

2250 Soquel Ave
#150
Santa Cruz, CA 95062
Phone (831) 600-2800

Organizations & group practices 7

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1205980729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTEIN",
        "first_name": "FREDDIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G073362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G733620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.