Individual provider Active NPI

Elizabeth Ann Weingarten, MD

  • Family Medicine Physician
  • East Aurora, NY
National Provider Identifier
1508820242
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257093-1 Issued in NY
Practice address
112 Olean St
Suite 220
East Aurora, NY 14052-2540
Phone
(716) 805-1072
Fax
(716) 805-1073
NPI assigned
Apr 12, 2006
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101238905 VA
Family Medicine Physician 207Q00000X 257093-1 NY Primary
Family Medicine Physician 207Q00000X 091622 OH

Addresses

Primary practice location

112 Olean St
Suite 220
East Aurora, NY 14052-2540

Mailing address

112 Olean St
Suite 220
East Aurora, NY 14052-2540
Phone (716) 805-1072

Other identifiers 2

IdentifierTypeStateIssuer
2845032MedicaidOH
7171378OtherOHCIGNA

Other names 1

  • Elizabeth Ann Grucella Former name

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
I20110425000009 NY Practitioner - Family Practice 4385660620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Aurora Family Practice,LLPGroup PAC ID 5496733404, 9 clinicians

Practice addresses (Care Compare)

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 805-1072

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257093-1NYMDFamily Medicine Physician
091622OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Aurora Family Practice,LLP Family Medicine CurrentSince Feb 2, 2011 Accepting new patients

Locations

112 Olean St
Ste 220
East Aurora, NY 14052
Phone (716) 805-1072

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1508820242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINGARTEN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238905",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "257093-1",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "091622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2845032",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7171378",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GRUCELLA",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Aurora, NY

Sources for this page

Verify at the official NPI Registry.