NPIMap

Organization Active NPI

Phillip Fyman and Alexander Weingarten MD PC

  • Interventional Pain Medicine Physician
  • Jericho, NY
National Provider Identifier
1386747947
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PHILLIP FYMAN AND ALEXANDER WEINGARTEN MD PC
Practice address
366 N Broadway Ste 305
Jericho, NY 11753-2000
Phone
(516) 496-4964
Fax
(516) 496-4950
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Sara Labieniec
Title
Manager
Phone
(516) 496-4964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

366 N Broadway Ste 305
Jericho, NY 11753-2000

Mailing address

366 N Broadway Ste 305
Jericho, NY 11753-2000
Phone (516) 496-4964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061211000136 NY Part B Supplier - Clinic/Group Practice 7719878719 Receives reassigned benefits from 9 practitioners
Practice locations: Jericho, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1093001Phillip Fyman and Alexander Weingarten MD PC366 North Broadway (Ste 305), Jericho, NY 11753ComplianceNov 1, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2001 Marcus Ave
Ste S20
New Hyde Park, NY 11042
Phone (516) 358-4673

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1386747947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 N BROADWAY STE 305",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532000",
            "telephone_number": "516-496-4964",
            "fax_number": "516-496-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 N BROADWAY STE 305",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532000",
            "telephone_number": "516-496-4964",
            "fax_number": "516-496-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP FYMAN AND ALEXANDER WEINGARTEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "LABIENIEC",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-496-4964"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.