Organization Active NPI

Richard B Weisberg PA

  • Family Medicine Physician
  • Stuart, FL
National Provider Identifier
1760633473
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS6866 Issued in FL
Legal business name
RICHARD B WEISBERG PA
Practice address
1141 SE Indian St Ste 101
Stuart, FL 34997-5764
Phone
(772) 221-7789
Fax
(772) 221-8584
NPI assigned
Oct 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Dr. Richard B Weisberg, D.ONPI 1598730608
Title
Physician
Phone
(772) 221-7789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS6866 FL Primary

Addresses

Primary practice location

1141 SE Indian St Ste 101
Stuart, FL 34997-5764

Mailing address

3511 SE Willoughby Blvd
Stuart, FL 34994-5059
Phone (772) 221-7789

Other identifiers 1

IdentifierTypeStateIssuer
271107900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081010000166 FL Part B Supplier - Clinic/Group Practice 8820166382 Receives reassigned benefits from 7 practitioners
Practice locations: Stuart, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0942267Richard B Weisberg DO1141 SE Indian Street Ste 101, Stuart, FL 34997Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory

Locations

1141 SE Indian St
Ste 101
Stuart, FL 34997
Phone (772) 221-7789

3511 SE Willoughby Blvd
Stuart, FL 34994
Phone (772) 221-7789

1141 SE Indian St
Stuart, FL 34997
Phone (772) 221-7789

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1760633473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945059",
            "telephone_number": "772-221-7789",
            "fax_number": "772-221-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 SE INDIAN ST STE 101",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349975764",
            "telephone_number": "772-221-7789",
            "fax_number": "772-221-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD B WEISBERG PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "772-221-7789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS6866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271107900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.