Individual provider Active NPI

Andrea Weissman, MACCC-SLP

  • Speech-Language Pathologist
  • Setauket, NY
National Provider Identifier
1811043029
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
006798 Issued in NY
Practice address
111 Gnarled Hollow Rd
Setauket, NY 11733-1931
Phone
(631) 689-2776
NPI assigned
Jan 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 006798 NY Primary

Addresses

Primary practice location

111 Gnarled Hollow Rd
Setauket, NY 11733-1931

Mailing address

111 Gnarled Hollow Rd
Setauket, NY 11733-1931
Phone (631) 689-2776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006798NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Services PC CurrentSince Jul 1, 2020 Accepting new patients
Epic Long Island CurrentSince Mar 1, 2021 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Mar 1, 2021 Accepting new patients

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

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.

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1811043029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GNARLED HOLLOW RD",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331931",
            "telephone_number": "631-689-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GNARLED HOLLOW RD",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331931",
            "telephone_number": "631-689-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "MACCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "006798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.