Individual provider Active NPI

Gregory Weidner, DO

  • Emergency Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1871021766
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
304513 Issued in NY
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
May 23, 2017
Last updated
Jun 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 304513 NY Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915

Other practice location 1

1825 Eastchester Rd
Bronx, NY 10461-2301
Phone (718) 904-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201023000109 NJ Practitioner - Emergency Medicine 4981024312 Reassigns benefits to 6 organizations
I20201125002056 NY Practitioner - Emergency Medicine 4981024312 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rite Medical Care PCGroup PAC ID 1153743307, 9 clinicians

Practice addresses (Care Compare)

154 Main Ave
Passaic, NJ 07055-5425
Phone (718) 534-0689

175 Route 59
Spring Valley, NY 10977-5231
Phone (718) 534-0689

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Emergency Medicine CurrentSince Jul 23, 2020 Accepting new patients
Valley Emergency Assoc PA Emergency Medicine CurrentSince Apr 4, 2023 Accepting new patients
Ihpnj ER LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Jul 23, 2020 Accepting new patients
Stadium Emergency Associates CurrentSince Jan 17, 2025 Accepting new patients
Parkway Anesthesia Associates LLC CurrentSince Nov 18, 2024 Accepting new patients
Garden State Healthcare Associates, LLC Emergency Medicine CurrentSince Aug 3, 2020 Accepting new patients
Rite Medical Care PC Emergency Medicine CurrentSince Mar 3, 2022 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine Current Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

17811 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 729-7282

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

175 Route 59
Spring Valley, NY 10977
Phone (845) 352-6800

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1871021766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Eastchester Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612301",
            "country_code": "US",
            "telephone_number": "718-904-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "304513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.