Individual provider Active NPI

Mark Weinstein, M.D.

  • Internal Medicine Physician
  • Bethpage, NY
National Provider Identifier
1407883176
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
141364 Issued in NY
Practice address
4277 Hempstead Tpke
Suite 209
Bethpage, NY 11714-5709
Phone
(516) 731-7770
Fax
(516) 731-7052
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 141364 NY Primary

Addresses

Primary practice location

4277 Hempstead Tpke
Suite 209
Bethpage, NY 11714-5709

Mailing address

4277 Hempstead Tpke
Suite 209
Bethpage, NY 11714-5709
Phone (516) 731-7770

Other identifiers 4

IdentifierTypeStateIssuer
110042183OtherNYRAILROAD MEDICARE
AP301OtherNYOXFORD
01407818MedicaidNY
0C5417OtherNYHEALTHNET

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
I20061004000251 NY Practitioner - Internal Medicine 7113936782

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Group, PC Internal Medicine Current Accepting new patients

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1407883176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4277 HEMPSTEAD TPKE",
            "address_2": "SUITE 209",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145709",
            "telephone_number": "516-731-7770",
            "fax_number": "516-731-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 HEMPSTEAD TPKE",
            "address_2": "SUITE 209",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145709",
            "telephone_number": "516-731-7770",
            "fax_number": "516-731-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTEIN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "141364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110042183",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AP301",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01407818",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0C5417",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.