Fruma Leah Wiederman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013097 Issued in NY

Practice address

1800 Rockaway Ave
Hewlett, NY 11557-1665

Phone

(516) 887-4335

NPI assigned

May 11, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• F. Leah Wiederman Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahava Medical and Rehabilitation Center, LLCGroup PAC ID 1557416997, 150 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: fwiederman@advderm.emadirect.md

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.

• Ahava Medical and Rehabilitation Center, LLC

  • Rehabilitation Practitioner
  • Brooklyn, NY
  • NPI 1184878274
  Medicare reassignment Care Compare group
• Advanced Dermatology PC

  • Dermatology Physician
  • New Hyde Park, NY
  • NPI 1134201460
  Medicare reassignment
• Anthony Buglino DO PLLC

  • Plastic Surgery Physician
  • Woodbury, NY
  • NPI 1730582834
  NPD (past)
• Howard D. Solomon, DO, PC

  • Procedural Dermatology Physician
  • Forest Hills, NY
  • NPI 1598054520
  NPD (past)

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1881828549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ROCKAWAY AVE",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571665",
            "telephone_number": "516-887-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ROCKAWAY AVE",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571665",
            "telephone_number": "516-887-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERMAN",
        "first_name": "FRUMA",
        "middle_name": "LEAH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "093097",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "F.",
            "last_name": "WIEDERMAN",
            "middle_name": "LEAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adrienne N Wecksell, LMSW
• Robert Weinstein, R.PH.
• Nina Noel Weisenreder, PH.D.
• Aviva Weisman, M.A. CCCSLP
• Levi Welton, PA-C
• Williamsburg Medical of New York LLC
• Jessica Wilson
• Ranan Chaim Wolff, DDS
• Jennifer Wong, RPA-C
• Kathleen Wozniak, CCC-SLP

• Physician Assistant in Hewlett, NY
• Providers in Hewlett, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.