Organization Active NPI

David J Weissberg, MD,PC

  • Durable Medical Equipment & Medical Supplies
  • Huntington Station, NY
National Provider Identifier
1821276577
Registry record updated Dec 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
146514 Issued in NY
Legal business name
DAVID J WEISSBERG, MD,PC
Practice address
379 Oakwood Rd
Suite C
Huntington Station, NY 11746-7203
Phone
(631) 351-0295
Fax
(631) 351-0265
NPI assigned
Feb 5, 2008
Last updated
Dec 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2019

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

Authorized official

Name
Stacy Lofredo
Title
Office Manager
Phone
(631) 351-0295

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 146514 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU

Addresses

Primary practice location

379 Oakwood Rd
Suite C
Huntington Station, NY 11746-7203

Mailing address

379 Oakwood Rd
Suite C
Huntington Station, NY 11746-7203
Phone (631) 351-0295

Other identifiers 1

IdentifierTypeStateIssuer
1720013097MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HUNTINGTONSTATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110301000005 NY Part B Supplier - Clinic/Group Practice 9537360151 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Islip, NY; Woodbury, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

175 E Main St
Ste 105
Huntington, NY 11743
Phone (631) 351-0295

379 Oakwood Rd
Ste C
Huntington Station, NY 11746
Phone (631) 351-0295

400 Montauk Hwy
Ste 108
West Islip, NY 11795
Phone (631) 351-0295

800 Woodbury Rd
Ste 100G
Woodbury, NY 11797
Phone (631) 351-0295

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577232000000",
    "number": "1821276577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 OAKWOOD RD",
            "address_2": "SUITE C",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467203",
            "telephone_number": "631-351-0295",
            "fax_number": "631-351-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 OAKWOOD RD",
            "address_2": "SUITE C",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467203",
            "telephone_number": "631-351-0295",
            "fax_number": "631-351-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J WEISSBERG, MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2019-12-25",
        "certification_date": "2019-12-25",
        "status": "A",
        "authorized_official_last_name": "LOFREDO",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-351-0295"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "146514",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720013097",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HUNTINGTONSTATION",
            "affiliation": "N",
            "address_1": "379 Oakwood Rd",
            "address_2": "SUITE C",
            "city": "Huntington Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117467203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.