Individual provider Active NPI

Clyde Herbert Weissbart, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1407925274
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
114479 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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 114479 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

3 Barker Ave
4TH Floor
White Plains, NY 10601-1509
Phone (914) 949-1199

Other practice location 1

3 Barker Ave
4th Floor
White Plains, NY 10601-1509
Phone (914) 949-1199

Other identifiers 1

IdentifierTypeStateIssuer
00779800MedicaidNY

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
I20050906000687 NY Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Hematology 8628000114 Reassigns benefits to 6 organizations
Practice locations: Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology
Education
New York Medical College, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronx Medical Practice PCGroup PAC ID 9739496100, 136 clinicians
Arcadian Medical Health PCGroup PAC ID 6800388372, 33 clinicians
Genesis Medical Health PCGroup PAC ID 9032308267, 44 clinicians

Practice addresses (Care Compare)

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

3525 Baychester Ave
Bronx, NY 10466-5001
Phone (845) 354-1212

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Apr 17, 2021 Accepting new patients
Essen Medical Associates,PC CurrentSince Apr 17, 2021 Accepting new patients
Genesis Medical Health PC Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients
Hospitalist Healthcare Services PLLC Internal Medicine CurrentSince Dec 11, 2013 Accepting new patients
Bronx Medical Practice P.C. Internal Medicine CurrentSince Apr 17, 2021 Accepting new patients
House Call Medical Services of New York, PLLC Internal Medicine CurrentSince Apr 17, 2021 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Forest Hills Dermatology Group PLLC PastSince Sep 1, 2012 Accepting new patients
RLD Medical Services, PC Internal Medicine PastSince Jul 1, 2001 Accepting new patients
White Plains Nursing Home, Inc. Past Accepting new patients
Jopal Bronx LLC Past Accepting new patients

Locations

100 W Kingsbridge Rd
Bronx, NY 10468
Phone (718) 410-1480

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

3155 Grace Ave
Bronx, NY 10469
Phone (718) 304-2866

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

930 Grand Concourse
Apt 1K
Bronx, NY 10451
Phone (212) 395-9000

3845 Carpenter Ave
Bronx, NY 10467
Phone (718) 269-3989

1072 Grand Concourse
Bronx, NY 10456
Phone (718) 681-4000

2015 Grand Concourse
#13202
Bronx, NY 10453

3525 Baychester Ave
Bronx, NY 10466
Phone 71867063001740

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

33 Downtown Dr
Monsey, NY 10952

15 Monsey Blvd
Monsey, NY 10952
Phone (845) 356-3400

116 E 125th St
New York, NY 10035
Phone (212) 395-9000

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1407925274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BARKER AVE",
            "address_2": "4TH FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011509",
            "telephone_number": "914-949-1199",
            "fax_number": "914-949-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Barker Ave",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106011509",
            "country_code": "US",
            "telephone_number": "914-949-1199",
            "fax_number": "914-949-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISSBART",
        "first_name": "CLYDE",
        "middle_name": "HERBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "114479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00779800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.