Individual provider Active NPI

Gerald Stanley Weinstein, M.D.

  • Vascular Surgery Physician
  • Santa Fe, NM
National Provider Identifier
1477552982
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2001121 Issued in NM
Practice address
1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Phone
(505) 913-3975
Fax
(505) 946-8001
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2001121 NM Primary
Vascular Surgery Physician 2086S0129X MD043777L PA

Addresses

Primary practice location

1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728

Mailing address

1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Phone (505) 913-3975

Other identifiers 3

IdentifierTypeStateIssuer
0012356470006MedicaidPA
A6265MedicaidNM
NM009337OtherNMBCBS OF NM

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

LicenseStateTypeSpecialty
MD011057EPAMDDiagnostic Ultrasound Physician
MD043777LPAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc Past Accepting new patients
Faith Regional Physician Services, LLC Past Accepting new patients
Faith Regional Physician Services, LLC PastSince Dec 28, 2015 Accepting new patients
New Mexico Cardiovascular Associates, PC Vascular Surgery Past Accepting new patients

Organizations & group practices 4

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1477552982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR",
            "address_2": "SUITE 240",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-913-3975",
            "fax_number": "505-946-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR",
            "address_2": "SUITE 240",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-913-3975",
            "fax_number": "505-946-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTEIN",
        "first_name": "GERALD",
        "middle_name": "STANLEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "2001121",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD043777L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012356470006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A6265",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "NM009337",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.