Individual provider Active NPI

Debra J Werner, MD

  • Gynecology Physician
  • Staten Island, NY
National Provider Identifier
1760577258
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
185682 Issued in NY
Practice address
27 New Dorp LN Ste 2
Staten Island, NY 10306-2314
Phone
(718) 668-1700
Fax
(718) 668-1733
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 185682 NY Primary

Addresses

Primary practice location

27 New Dorp LN Ste 2
Staten Island, NY 10306-2314

Mailing address

83 Westminster CT
Staten Island, NY 10304-1313
Phone (718) 668-1700

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000566 NY Practitioner - Obstetrics/Gynecology 6709804685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27 New Dorp LN
Suite 2
Staten Island, NY 10306-2314
Phone (718) 668-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185682NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Obstetrics and Gynecology CurrentSince Sep 9, 2005 Accepting new patients
Richmond University Medical Center Past Accepting new patients
Richmond Medical Center Past Accepting new patients

Locations

1975 Hylan Blvd
Ste 1
Staten Island, NY 10306
Phone (718) 667-5400

27 New Dorp Ln
Ste 2
Staten Island, NY 10306
Phone (718) 668-1700

Organizations & group practices 3

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1760577258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 WESTMINSTER CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041313",
            "telephone_number": "718-668-1700",
            "fax_number": "718-668-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 NEW DORP LN STE 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062314",
            "telephone_number": "718-668-1700",
            "fax_number": "718-668-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-05-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "185682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.