Individual provider Active NPI

Susan Rochel Weibman, PA-C

  • Physician Assistant
  • Hawthorne, NY
National Provider Identifier
1578251989
Registry record updated Apr 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027796-01 Issued in NY
Practice address
19 Bradhurst Ave Ste 3090N
Hawthorne, NY 10532-2140
Phone
(914) 493-2181
NPI assigned
Apr 25, 2023
Last updated
Apr 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027796-01 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave Ste 3090N
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave Ste 3090N
Hawthorne, NY 10532-2140
Phone (914) 493-2181

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230519002077 NY Practitioner - Physician Assistant 2668838400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Baker Ave
Suite 101
Poughkeepsie, NY 12601-1379
Phone (845) 483-5997

19 Bradhurst Ave
Hawthorne, NY 10532-2140

785 State Route 17M
Suite 17
Monroe, NY 10950-2629
Phone (845) 782-9449

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027796-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jul 11, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Gynecologic Oncology CurrentSince Jul 11, 2023 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3090N
Hawthorne, NY 10532
Phone (914) 493-2181

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

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.

Hospital & facility affiliations 4

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682812800000",
    "number": "1578251989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3090N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-493-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3090N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-493-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBMAN",
        "first_name": "SUSAN",
        "middle_name": "ROCHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-30",
        "certification_date": "2023-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027796-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.