Individual provider Active NPI

Joseph Burt Weissberg, MD

  • Radiation Oncology Physician
  • Middletown, CT
National Provider Identifier
1720193113
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
02174 Issued in CT
Practice address
536 Saybrook Road
Middlesex Hospital Cancer Center
Middletown, CT 06457
Phone
(860) 358-2100
Fax
(860) 358-2110
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 02174 CT Primary

Addresses

Primary practice location

536 Saybrook Road
Middlesex Hospital Cancer Center
Middletown, CT 06457

Mailing address

760 Saybrook Road
Middletown, CT 06457
Phone (860) 704-0106

Other identifiers 1

IdentifierTypeStateIssuer
001217454MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20070228000441 CT Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 5294837878 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02174CTMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Connecticut Radiation Oncology PC Radiation Oncology CurrentSince Jan 1, 2006 Accepting new patients
Central Connecticut Radiation Oncology PC Radiation Oncology CurrentSince Feb 1, 1987 Accepting new patients

Locations

536 Saybrook Rd
#C
Middletown, CT 06457
Phone (860) 358-2100

760 Saybrook Rd
Bldg A
Middletown, CT 06457

536 Saybrook Rd
Middletown, CT 06457
Phone (860) 358-2100

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1720193113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 SAYBROOK ROAD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-704-0106",
            "fax_number": "860-704-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SAYBROOK ROAD",
            "address_2": "MIDDLESEX HOSPITAL CANCER CENTER",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-358-2100",
            "fax_number": "860-358-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSBERG",
        "first_name": "JOSEPH",
        "middle_name": "BURT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": "02174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001217454",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.