Individual provider Active NPI

Stephanie Ruth Weiss, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Schenectady, NY
National Provider Identifier
1548553365
Registry record updated Sep 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
267183 Issued in NY
Practice address
600 McClellan St
Schenectady, NY 12304-1009
Phone
(518) 382-2270
NPI assigned
May 26, 2011
Last updated
Sep 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 267183 NY Primary

Addresses

Primary practice location

600 McClellan St
Schenectady, NY 12304-1009

Mailing address

1809 Potter Rd
Amsterdam, NY 12010-8522
Phone (518) 382-2270

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630001939 NY Practitioner - Oral Surgery 9234441403 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267183NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Jul 3, 2015 Accepting new patients

Locations

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441411200000",
    "number": "1548553365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 POTTER RD",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120108522",
            "telephone_number": "518-382-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MCCLELLAN ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041009",
            "telephone_number": "518-382-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "STEPHANIE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2015-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "267183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.