Individual provider Active NPI

Douglas N Weiner, DPM

  • Podiatrist
  • Bronx, NY
National Provider Identifier
1679535017
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N0043481 Issued in NY
Practice address
1150 Webster Ave
Bronx, NY 10456-5205
Phone
(347) 271-5338
Fax
(347) 726-8264
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N0043481 NY Primary

Addresses

Primary practice location

1150 Webster Ave
Bronx, NY 10456-5205

Mailing address

1150 Webster Ave Ste 2
Bronx, NY 10456-5205
Phone (347) 271-5338

Other identifiers 1

IdentifierTypeStateIssuer
01052515MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060731000200 NY Practitioner - Podiatry 4486667979 Reassigns benefits to 6 organizations
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N0043481NYMDPodiatrist
004348NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Medical Family Practice PC CurrentSince Oct 1, 2022 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Mar 24, 2024 Accepting new patients
Ag Urgent Care, P.C. CurrentSince Dec 1, 2022 Accepting new patients
Essen Medical Associates,PC CurrentSince Mar 24, 2024 Accepting new patients

Locations

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

4809 Avenue N
Brooklyn, NY 11234
Phone (718) 252-4120

1295 Broadway
Brooklyn, NY 11221
Phone (718) 682-3903

9525 Church Ave
Brooklyn, NY 11212
Phone (718) 513-6178

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

16814 Jamaica Ave
Jamaica, NY 11432
Phone (718) 650-5553

Networks

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

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1679535017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 WEBSTER AVE STE 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565205",
            "telephone_number": "347-271-5338",
            "fax_number": "347-726-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565205",
            "telephone_number": "347-271-5338",
            "fax_number": "347-726-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "DOUGLAS",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N0043481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01052515",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.