Individual provider Active NPI

Mark G Weiner, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1568499465
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
300121 Issued in NY
Practice address
505 E 70TH St FL 4
New York, NY 10021-4872
Phone
(212) 746-2900
Fax
(212) 746-4609
NPI assigned
Jun 27, 2006
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD053756L PA
Internal Medicine Physician 207R00000X 300121 NY Primary

Addresses

Primary practice location

505 E 70TH St FL 4
New York, NY 10021-4872

Mailing address

505 E 70TH St FL 4
New York, NY 10021-4872
Phone (212) 746-2900

Other identifiers 1

IdentifierTypeStateIssuer
0015348450009MedicaidPA

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
I20191003001813 NY Practitioner - Internal Medicine 3779614714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

505 E 70TH St
New York, NY 10021-4872
Phone (212) 746-2917

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD053756LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 18, 2019 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell Internal Medicine CurrentSince Aug 18, 2019 Accepting new patients

Locations

1300 York Ave
New York, NY 10065
Phone (212) 746-2900

505 E 70th St
New York, NY 10021
Phone (212) 746-2900

505 E 70th St
Fl 4
New York, NY 10021
Phone (212) 746-2900

Interoperability endpoints

  • Direct secure messaging: mgw4001@direct.nyp.org

Organizations & group practices 3

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1568499465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-2900",
            "fax_number": "215-707-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-2900",
            "fax_number": "212-746-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "MARK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD053756L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "300121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015348450009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.