Individual provider Active NPI

Corey J Weiner, MD

  • Diagnostic Radiology Physician
  • Elmont, NY
National Provider Identifier
1891720272
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
239107 Issued in NY
Practice address
545 Elmont Rd
Elmont, NY 11003-4002
Phone
(516) 495-7129
Fax
(516) 977-2874
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MA46748 NJ
Diagnostic Radiology Physician 2085R0202X 239107 NY Primary

Addresses

Primary practice location

545 Elmont Rd
Elmont, NY 11003-4002

Mailing address

545 Elmont Rd
Elmont, NY 11003-4002
Phone (516) 495-7129

Other identifiers 1

IdentifierTypeStateIssuer
05219906MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000917 NY Practitioner - Diagnostic Radiology 6406757947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA46748NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Medical & Diagnostic Center Inc CurrentSince Dec 31, 2016 Accepting new patients
Quality Medical Imaging of Arizona, Inc CurrentSince Nov 30, 2020 Accepting new patients
Sancor Medical Enterprises, LLC Diagnostic Radiology PastSince Apr 30, 2003 Accepting new patients
Park West Radiology, PC Diagnostic Radiology PastSince Jul 1, 2008 Accepting new patients
Imaging Consultants of Essex, P.a. Diagnostic Radiology Past Accepting new patients
North Shore Health System Medical Faculty Group Practice Inc Past Accepting new patients
Advanced Imaging and Radiology Assoc Diagnostic Radiology PastSince Jun 17, 1992 Accepting new patients
Mahwah Radiology Associates Diagnostic Radiology Past Accepting new patients
Os Management Company LLC Diagnostic Radiology Past Accepting new patients
DRS. Beranbaum, Khilnani, Neistadt, Jacobs, Hertz & Sherman, LLP Diagnostic Radiology Past Accepting new patients
Howard Kessler MD PA Diagnostic Radiology Past Accepting new patients

Locations

8046 Kew Gardens Rd
Kew Gardens, NY 11415
Phone (718) 261-1000

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1891720272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034002",
            "telephone_number": "516-495-7129",
            "fax_number": "516-977-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034002",
            "telephone_number": "516-495-7129",
            "fax_number": "516-977-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "COREY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "MA46748",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "239107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05219906",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

Verify at the official NPI Registry.