Individual provider Active NPI

Barbra Weitz

  • Clinical Social Worker
  • Southampton, NY
National Provider Identifier
1881742492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R021964-1 Issued in NY
Practice address
28 Cedar Dr
Southampton, NY 11968-4227
Phone
(631) 283-6179
Fax
(631) 287-9544
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R021964-1 NY Primary

Addresses

Primary practice location

28 Cedar Dr
Southampton, NY 11968-4227

Mailing address

28 Cedar Dr
Southampton, NY 11968-4227
Phone (631) 283-6179

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000627 NY Practitioner - Clinical Social Worker 5890819817 Practice locations: Holtsville, NY; Southampton, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Cedar Dr
Southampton, NY 11968-4227
Phone (631) 283-6179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R021964-1NYMDClinical Social Worker
021964NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881742492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CEDAR DR",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684227",
            "telephone_number": "631-283-6179",
            "fax_number": "631-287-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CEDAR DR",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684227",
            "telephone_number": "631-283-6179",
            "fax_number": "631-287-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZ",
        "first_name": "BARBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R021964-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.