Active NPI
David J Weissberg, MD,PC
- Durable Medical Equipment & Medical Supplies
- Huntington Station, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 146514
- 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, 2019
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720013097 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HUNTINGTONSTATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Orthopaedic Hand Surgery Physician
- Smithtown, NY
- NPI 1568781268
-
- Orthopaedic Surgery Physician
- Woodbury, NY
- NPI 1720013097
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.