Steven P. Bleiweiss MD, Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G20642 Issued in CA

Legal business name

STEVEN P. BLEIWEISS MD, INC

Practice address

2101 Waterman
San Bernardino, CA 92404

Phone

(909) 881-4522

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Steven P Bleiweiss

Title

MD/President

Phone

(909) 881-6711

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kennedy Surgical Pathology Medical Associates, Inc Doing business as

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1306915764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6015-0015",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906300015",
            "telephone_number": "714-236-4000",
            "fax_number": "714-236-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WATERMAN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-881-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN P. BLEIWEISS MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "BLEIWEISS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "909-881-6711"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G20642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ02881Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088961",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Surgical Pathology Medical Associates, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Danielle Megan Stettler
• Jonathan Stevens
• Stephen Stevens, P.A.
• Jaffna Sheen Dayag Stevenson, MSN, FNP-BC, NP-C
• Rachel L Steward, M.D.
• Amelia Ray Stewart

• Anatomic Pathology & Clinical Pathology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.