Active NPI
Mark H. Weinstein, M.D.
- Plastic Surgery Physician
- New Haven, CT
National Provider Identifier
1407899073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 018620
- Practice address
- 136 Sherman Ave
#407
New Haven, CT 06511-5238 - Phone
- (203) 624-0673
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 018620 | CT | Primary |
Addresses
Primary practice location
136 Sherman Ave
#407
New Haven, CT 06511-5238
Mailing address
136 Sherman Ave
Suite 407
New Haven, CT 06511-5238
Phone (203) 624-0673
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NHS110 | Other | CT | OXFORD |
| 0Q0135 | Other | CT | HEALTHNET ID |
| 186200 | Other | CT | CTCARE |
| 010018620CT01 | Other | CT | ANTHEM ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018620 | CT | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Raphael Faculty Physicians | Past | 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.
-
- Internal Medicine Physician
- New Haven, CT
- NPI 1932138138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1407899073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 SHERMAN AVE",
"address_2": "SUITE 407",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115238",
"telephone_number": "203-624-0673",
"fax_number": "203-907-4593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 SHERMAN AVE",
"address_2": "#407",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115238",
"telephone_number": "203-624-0673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINSTEIN",
"first_name": "MARK",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CT",
"license": "018620",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "NHS110",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET ID",
"identifier": "0Q0135",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CTCARE",
"identifier": "186200",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM ID",
"identifier": "010018620CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.