Active NPI
Alan B. Weiner, MD
- Family Medicine Physician
- Cherry Hill, NJ
National Provider Identifier
1760456057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 73864
- Practice address
- 401 Kings Hwy S
Cherry Hill, NJ 08034-2500 - Phone
- (856) 475-6166
- NPI assigned
- Feb 14, 2006
- Last updated
- Feb 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 73864 | MA | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 25MA11214200 | NJ |
Addresses
Primary practice location
401 Kings Hwy S
Cherry Hill, NJ 08034-2500
Mailing address
474 Grove St
Worcester, MA 01605-1214
Phone (508) 403-7877
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-3194547 | Other | MA | GREAT-WEST |
| 04-3194547 | Other | MA | NORTHEAST HEALTH DIRECT |
| 04-3194547 | Other | MA | PRIVATE HEALTHCARE SYSTEM |
| 2358647 | Other | MA | AETNA |
| 04-3194547 | Other | MA | NORTH AMERICAN PREFERRED |
| 71794 | Other | MA | HARVARD PILGRIM |
| 04-3194547 | Other | MA | NORTHEAST HEALTHCARE ALLI |
| J11185 | Other | MA | BCBSMA |
| 000000007921 | Other | MA | BMC |
| 04-3194547 | Other | MA | PLAN VISTA |
| 1024160 | Other | MA | CIGNA |
| 073864 | Other | MA | TUFTS |
| 04-3194547 | Other | MA | CONSOLIDATED |
| 04-3194547 | Other | MA | UNICARE/GIC |
| 3077225 | Medicaid | MA | |
| 20409 | Other | MA | HEALTH NEW ENGLAND |
| 738641 | Other | MA | CONNECTICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA11214200 | NJ | MD | Addiction Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eleanor Health Professional NC, PLLC | Addiction Medicine | Current | Accepting new patients |
Locations
2402 S Miami Blvd
Ste 101
Durham, NC 27703
Phone (919) 765-8730
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Hickory, NC
- NPI 1891349155
Addiction Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1760456057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 GROVE ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051214",
"telephone_number": "508-403-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 KINGS HWY S",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080342500",
"telephone_number": "856-475-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINER",
"first_name": "ALAN",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "73864",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "NJ",
"license": "25MA11214200",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT-WEST",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHEAST HEALTH DIRECT",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2358647",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICAN PREFERRED",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "71794",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHEAST HEALTHCARE ALLI",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA",
"identifier": "J11185",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC",
"identifier": "000000007921",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PLAN VISTA",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1024160",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "073864",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONSOLIDATED",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE/GIC",
"identifier": "04-3194547",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3077225",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "20409",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "738641",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.