Individual provider Active NPI

Carla Isabel Weisfeld, DDS

  • General Practice Dentistry
  • Port Chester, NY
National Provider Identifier
1750547766
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053951-1 Issued in NY
Practice address
110 Willett Ave
Port Chester, NY 10573-4282
Phone
(914) 937-3733
Fax
(914) 937-3733
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 053951-1 NY Primary

Addresses

Primary practice location

110 Willett Ave
Port Chester, NY 10573-4282

Mailing address

18 Bronx St
Tuckahoe, NY 10707-3302
Phone (646) 546-7036

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
I20150629002715 NY Order and Referring Only - DentistPractitioner - Dentist 7911219225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053951-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carla Weisfeld DDS, P.C. CurrentSince Sep 17, 2023 Accepting new patients

Locations

8916 Roosevelt Ave
#2
Jackson Heights, NY 11372

110 Willett Ave
Port Chester, NY 10573
Phone (914) 937-3733

Organizations & group practices 1

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1750547766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BRONX ST",
            "city": "TUCKAHOE",
            "state": "NY",
            "postal_code": "107073302",
            "telephone_number": "646-546-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WILLETT AVE",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734282",
            "telephone_number": "914-937-3733",
            "fax_number": "914-937-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISFELD",
        "first_name": "CARLA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053951-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.