Individual provider Active NPI

Lisa Hutchison Weiss, M.D.

  • Child & Adolescent Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1235367418
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
285693 Issued in NY
Practice address
3340 Bainbridge Ave
Bronx, NY 10467-2802
Phone
(718) 696-3011
Fax
(718) 405-5953
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61467953 WA
Pediatrics Physician 208000000X 285693 NY
Psychiatry Physician 2084P0800X 61467953 WA
Psychiatry Physician 2084P0800X 285693 NY
Child & Adolescent Psychiatry Physician 2084P0804X 61467953 WA
Child & Adolescent Psychiatry Physician 2084P0804X 285693 NY Primary

Addresses

Primary practice location

3340 Bainbridge Ave
Bronx, NY 10467-2802

Mailing address

3340 Bainbridge Ave
Bronx, NY 10467-2802
Phone (718) 696-3011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181017003274 NY Practitioner - Psychiatry 5092039792 Reassigns benefits to 1 organization
I20240609000144 WA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 5092039792 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285693NYMDChild & Adolescent Psychiatry Physician
61467953WAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 14, 2018 Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince May 29, 2024 Accepting new patients
Association of CHMC and University Physicians Pediatrics CurrentSince May 29, 2024 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Sep 14, 2018 Accepting new patients
Seattle Children's Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3340 Bainbridge Ave
Bronx, NY 10467
Phone (718) 696-3011

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

Interoperability endpoints

  • Direct secure messaging: lweiss370253@direct.seattlechildrens.org

Organizations & group practices 5

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1235367418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672802",
            "telephone_number": "718-696-3011",
            "fax_number": "718-405-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672802",
            "telephone_number": "718-696-3011",
            "fax_number": "718-405-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "LISA",
        "middle_name": "HUTCHISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61467953",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "285693",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "61467953",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "285693",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "61467953",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "285693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.