Individual provider Active NPI

Carla Canavire Weber, DO

  • Family Medicine Physician
  • Bay Shore, NY
National Provider Identifier
1578632899
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2108831 Issued in NY
Practice address
1745 Union Blvd
Bay Shore, NY 11706-7952
Phone
(631) 328-5560
Fax
(631) 328-5559
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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 2108831 NY Primary

Addresses

Primary practice location

1745 Union Blvd
Bay Shore, NY 11706-7952

Mailing address

1745 Union Blvd
Bay Shore, NY 11706-7952
Phone (631) 328-5560

Other identifiers 1

IdentifierTypeStateIssuer
01933499MedicaidNY

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
I20040319001561 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1153212253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Care of Bayshore, PCGroup PAC ID 8921143751, 3 clinicians

Practice addresses (Care Compare)

1745 Union Blvd
Bay Shore, NY 11706-7952
Phone (631) 328-5560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2108831NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Care of Bayshore, PC Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
Long Island Osteoporosis & Arthritis Center Current Accepting new patients

Locations

1745 Union Blvd
Bay Shore, NY 11706
Phone (631) 328-5560

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20167/brand/1/csg/1/fhir/r4
  • Direct secure messaging: carla.canavire-weber.1@20167.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1578632899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-328-5560",
            "fax_number": "631-328-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-328-5560",
            "fax_number": "631-328-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVIRE WEBER",
        "first_name": "CARLA",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "2108831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01933499",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.