Edward Wiedemann

Primary specialty

Social WorkerTaxonomy code 104100000X

License

106818 Issued in NY

Practice address

191 Bethpage Sweet Hollow Rd
Old Bethpage, NY 11804-1342

Phone

(516) 870-1600

NPI assigned

Apr 21, 2021

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1265013197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SADDLE LN",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202512",
            "telephone_number": "646-351-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 BETHPAGE SWEET HOLLOW RD",
            "city": "OLD BETHPAGE",
            "state": "NY",
            "postal_code": "118041342",
            "telephone_number": "516-870-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMANN",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewiedemann02@familyres.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "191 Bethpage Sweet Hollow Rd",
            "city": "Old Bethpage",
            "state": "NY",
            "country_code": "US",
            "postal_code": "118041342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paula Sussman, LCSW
• Richa Tevatia, M.D.
• Saju Idicula Varghese, PT
• Dawn Wegard
• Diane Weinstein, LCSW
• Marci Zaslav, LCSW
• Jill R Zeilander, M.S.,CCC-SLP

• Social Worker in Old Bethpage, NY
• Providers in Old Bethpage, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.