Individual provider Active NPI

Lee B Weitzman, MD

  • Cardiovascular Disease Physician
  • Long Beach, NY
National Provider Identifier
1821058124
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
139593 Issued in NY
Practice address
325 W Park Ave
Long Beach, NY 11561-3223
Phone
(516) 432-2004
Fax
(516) 432-4154
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 139593 NY Primary

Addresses

Primary practice location

325 W Park Ave
Long Beach, NY 11561-3223

Mailing address

325 W Park Ave
Long Beach, NY 11561-3223
Phone (516) 432-2004

Other identifiers 1

IdentifierTypeStateIssuer
00767813MedicaidNY

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
I20040420000968 NY Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9032104799 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Cardiovascular Disease CurrentSince Feb 1, 2019 Accepting new patients
Mount Sinai School of Medicine Current Accepting new patients
Mount Sinai School of Medicine CurrentSince Feb 1, 2019 Accepting new patients

Locations

325 W Park Ave
Long Beach, NY 11561
Phone (516) 255-1600

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1821058124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613223",
            "telephone_number": "516-432-2004",
            "fax_number": "516-432-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613223",
            "telephone_number": "516-432-2004",
            "fax_number": "516-432-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZMAN",
        "first_name": "LEE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "139593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00767813",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.