Active NPI
Karissa Lee Weidman, M.D.
- Internal Medicine Physician
- Stony Brook, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 267452
- Practice address
- 101 Nicolls Rd Ofc T17-040
Stony Brook, NY 11794-0001 - Phone
- (631) 444-3869
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 267452 | MA | Primary |
Addresses
Primary practice location
101 Nicolls Rd Ofc T17-040
Stony Brook, NY 11794-0001
Mailing address
101 Nicolls Rd Ofc T17-040
Stony Brook, NY 11794-0001
Phone (631) 444-3869
Other practice location 1
525 E 68th St
New York, NY 10065-4870
Phone (646) 962-2333
Other practice location 2
800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- New York Medical College, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stony Brook Internists University Faculty Practice Corporation
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
101 Nicolls Rd
Stony Brook, NY 11794-0001
26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580
Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000
PO Box
Suite 1554
Stony Brook, NY 11790-0989
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309477 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Current | Accepting new patients |
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients |
Locations
26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502
101 Nicolls Rd
Ofc T17040
Stony Brook, NY 11794
Phone (631) 444-3869
100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
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 and National Provider Directory roles.
-
- Cardiac Rehabilitation Registered Nurse
- Stony Brook, NY
- NPI 1295778371
-
- Internal Medicine Physician
- Stony Brook, NY
- NPI 1821035601
-
- Pulmonary Disease Physician
- Stony Brook, NY
- NPI 1104865229
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Stony Brook Southampton Hospital
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1598113078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 NICOLLS RD OFC T17-040",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-444-3869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NICOLLS RD OFC T17-040",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-444-3869"
}
],
"practiceLocations": [
{
"address_1": "525 E 68th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100654870",
"country_code": "US",
"telephone_number": "646-962-2333",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 Washington St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021111552",
"country_code": "US",
"telephone_number": "617-636-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEIDMAN",
"first_name": "KARISSA",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-25",
"last_updated": "2025-09-11",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "267452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.