Individual provider Active NPI

Steve Eric Weissman, PH.D.

  • Clinical Psychologist
  • Great Neck, NY
National Provider Identifier
1457556748
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017188 Issued in NY
Practice address
935 Northern Blvd
Suite #102
Great Neck, NY 11021-5309
Phone
(516) 487-7116
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 017188 NY Primary

Addresses

Primary practice location

935 Northern Blvd
Suite #102
Great Neck, NY 11021-5309

Mailing address

7508 Bell Blvd Apt 1K
Oakland Gardens, NY 11364-3402
Phone (718) 468-8646

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000461 NY Practitioner - Clinical Psychologist 6901989474 Practice locations: New York, NY; Rockville Centre, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 N Village Ave
Suite 11
Rockville Centre, NY 11570-3712
Phone (917) 796-7863

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017188NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Psychological Services PC Past Accepting new patients
Keith Woythaler Psychologist, P.C. Clinical PastSince Jan 1, 2018 Accepting new patients

Organizations & group practices 2

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457556748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7508 BELL BLVD APT 1K",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643402",
            "telephone_number": "718-468-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 NORTHERN BLVD",
            "address_2": "SUITE #102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215309",
            "telephone_number": "516-487-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "STEVE",
        "middle_name": "ERIC",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.