Organization Active NPI

Meeting House Lane Medical Practice PC

  • Internal Medicine Physician
  • Southampton, NY
National Provider Identifier
1902088495
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEETING HOUSE LANE MEDICAL PRACTICE PC
Practice address
57 Hampton Rd
Suite 201
Southampton, NY 11968-4973
Phone
(631) 283-2430
Fax
(631) 283-7496
NPI assigned
Nov 27, 2007
Last updated
Nov 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Authorized official

Name
Dr. Fredrick I Weinbaum, MD
Title
President
Phone
(631) 726-8332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

57 Hampton Rd
Suite 201
Southampton, NY 11968-4973

Mailing address

57 Hampton Rd
Suite 201
Southampton, NY 11968-4973
Phone (631) 283-2430

Other identifiers 1

IdentifierTypeStateIssuer
031402436MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326000089 NY Part B Supplier - Clinic/Group Practice 6800972589 Receives reassigned benefits from 140 practitioners
Practice locations: Riverhead, NY; Sag Harbor, NY; Southampton, NY; Wainscott, NY; East Hampton, NY; Water Mill, NY; Westhampton Beach, NY; Lhampton Bays, NY…

National Provider Directory

National Provider Directory

Locations

182 W Montauk Hwy
Ste B
Hampton Bays, NY 11946
Phone (631) 594-3910

182 W Montauk Hwy
Ste F
Hampton Bays, NY 11946
Phone (631) 726-8400

4 Springville Rd
Ste B
Hampton Bays, NY 11946

28 S Etna Ave
Montauk, NY 11954
Phone (631) 668-3705

1333 Heroes Way
Ste 203
Riverhead, NY 11901

715 Roanoke Ave
Ste 7
Riverhead, NY 11901
Phone (631) 726-8400

117 Hampton Rd
Southampton, NY 11968
Phone (631) 287-8600

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

240 Meeting House Ln
Ste 3
Southampton, NY 11968
Phone (631) 726-8264

325 Meeting House Ln
Bldg 2
Southampton, NY 11968
Phone (631) 283-2100

325 Meeting House Ln
Fl 1
Southampton, NY 11968

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

57 Hampton Rd
Ste 201
Southampton, NY 11968
Phone (631) 283-1126

860 Montauk Hwy
Water Mill, NY 11976
Phone (631) 726-6073

860 Montauk Hwy
Unit 7
Water Mill, NY 11976

Practitioners & affiliated clinicians

Practitioners 165

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.

View all 165

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1902088495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 HAMPTON RD",
            "address_2": "SUITE 201",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684973",
            "telephone_number": "631-283-2430",
            "fax_number": "631-283-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 HAMPTON RD",
            "address_2": "SUITE 201",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684973",
            "telephone_number": "631-283-2430",
            "fax_number": "631-283-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEETING HOUSE LANE MEDICAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "WEINBAUM",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-726-8332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031402436",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.

Verify at the official NPI Registry.