Theresa Marie Wegman, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

204233 Issued in NY

Practice address

24 Carrow St
Orchard Park, NY 14127-2604

Phone

(716) 662-3443

Fax

(716) 972-0374

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Carrow Street Pediatrics, PLLC

  • Pediatric Adolescent Medicine Physician
  • Orchard Park, NY
  • NPI 1902098494
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1437117553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CARROW ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272604",
            "telephone_number": "716-662-3443",
            "fax_number": "716-972-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CARROW ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272604",
            "telephone_number": "716-662-3443",
            "fax_number": "716-972-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGMAN",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "204233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01924689",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA HEALTHCARE)",
            "identifier": "00020530902",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROS/BLUE SHEILD (HEALTH NOW)",
            "identifier": "000525566002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH ASSOCIATION",
            "identifier": "1210624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Weber, LMSW
• Maria R Weber, RD
• Karen Weddle
• Wee Can Preschool
• Joshua E Weeks, PA
• Beth Mara Weiss, PNP
• Steven Daniel Weiss, MD
• Janet B. Westenberger Heywood, D.O.
• Western New York DC, LLC
• Western New York Ear, Nose & Throat, P.C.

• Pediatric Adolescent Medicine Physician in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Pediatric Adolescent Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.