Individual provider Active NPI

Richard John Wieting, M.D.

  • Internal Medicine Physician
  • Port Jefferson Station, NY
National Provider Identifier
1639158678
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225618 Issued in NY
Practice address
116 Terryville Rd
Port Jefferson Station, NY 11776-1329
Phone
(631) 928-2002
Fax
(631) 928-4934
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 225618 NY Primary

Addresses

Primary practice location

116 Terryville Rd
Port Jefferson Station, NY 11776-1329

Mailing address

38 Rolling Rd
Miller Place, NY 11764-2217
Phone (631) 331-0633

Other identifiers 1

IdentifierTypeStateIssuer
02313720MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20071030000563 NC Practitioner - HospitalistPractitioner - Internal Medicine 7416053707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-4380

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Jun 5, 2017 Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Mar 11, 2017 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Nov 1, 2020 Accepting new patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients
Terryville Medical Associates Past Accepting new patients
North Shore Internal Medicine, PC Internal Medicine Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2858/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639158678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ROLLING RD",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642217",
            "telephone_number": "631-331-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 TERRYVILLE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761329",
            "telephone_number": "631-928-2002",
            "fax_number": "631-928-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETING",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02313720",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.