Individual provider Active NPI

Jerry C Weinberg, MD

  • Ophthalmology Physician
  • Brooklyn, NY
National Provider Identifier
1306890785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
219927 Issued in NY
Practice address
1215 Avenue M
Brooklyn, NY 11230-5245
Phone
(718) 965-2020
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD028446E PA
Ophthalmology Physician 207W00000X 219927 NY Primary

Addresses

Primary practice location

1215 Avenue M
Brooklyn, NY 11230-5245

Mailing address

236A Moore Street
Pennsport Mall
Philadelphia, PA 19148
Phone (215) 755-9470

Other identifiers 2

IdentifierTypeStateIssuer
0009468220003MedicaidPA
02196234MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050218000453 NY Practitioner - Ophthalmology 2860444718 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of Ny Upstate Medical University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1215 Ave M
Brooklyn, NY 11230-5245
Phone (215) 755-9470

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219927NYMDOphthalmology Physician
MD028446EPAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
On-Sight Care LLC Ophthalmology Current Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306890785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236A MOORE STREET",
            "address_2": "PENNSPORT MALL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-755-9470",
            "fax_number": "215-755-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305245",
            "telephone_number": "718-965-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERG",
        "first_name": "JERRY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD028446E",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "219927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009468220003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02196234",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.