Individual provider Active NPI

Steven I Weisberger, D.O.

  • Family Medicine Physician
  • Jonesport, ME
National Provider Identifier
1528094554
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1102 Issued in ME
Practice address
70 Snare Creek LN
Jonesport, ME 04649-3139
Phone
(207) 497-5614
Fax
(207) 497-5554
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1102 ME Primary

Addresses

Primary practice location

70 Snare Creek LN
Jonesport, ME 04649-3139

Mailing address

70 Snare Creek LN
Jonesport, ME 04649-3139
Phone (207) 497-5614

Other identifiers 1

IdentifierTypeStateIssuer
257740099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20050711000391 ME Practitioner - Family Practice 8426945981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

277 State St
Suite 1B
Bangor, ME 04401-5440
Phone (207) 956-0951

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1102MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Winds LLC CurrentSince May 28, 2022 Accepting new patients
Chandler Bay Group, Inc PastSince Feb 1, 1991 Accepting new patients

Locations

277 State St
Ste 1B
Bangor, ME 04401
Phone (207) 922-4000

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1528094554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SNARE CREEK LN",
            "city": "JONESPORT",
            "state": "ME",
            "postal_code": "046493139",
            "telephone_number": "207-497-5614",
            "fax_number": "207-497-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 SNARE CREEK LN",
            "city": "JONESPORT",
            "state": "ME",
            "postal_code": "046493139",
            "telephone_number": "207-497-5614",
            "fax_number": "207-497-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBERGER",
        "first_name": "STEVEN",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257740099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesport, ME

Sources for this page

Verify at the official NPI Registry.