Kristel M. Weidenman, P.T., M.A.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015674-1 Issued in NY

Practice address

713 Walt Whitman Rd
Suite B
Melville, NY 11747-2202

Phone

(631) 425-5900

Fax

(631) 424-9850

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Glen Cove Physical Therapy, P.C.

  • Physical Therapist
  • Glen Cove, NY
  • NPI 1558389379
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1912014333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 WALT WHITMAN RD",
            "address_2": "SUITE B",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472202",
            "telephone_number": "631-425-5900",
            "fax_number": "631-424-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 WALT WHITMAN RD",
            "address_2": "SUITE B",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472202",
            "telephone_number": "631-425-5900",
            "fax_number": "631-424-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDENMAN",
        "first_name": "KRISTEL",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "P.T., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-06-17",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015674-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Patricia Waugh-Blake
• We Care for Eyes Inc
• Lianne Marie Webb
• Lauren Webster, D.P.T.
• Darren J. Weidenman, P.T., M.A.
• Clifford Weingarten
• Meryl Weinkranz, SLP
• Jenna Lisette Weinstein
• Laura Weinstein
• Robert Raphael Weiss, MD

• Physical Therapist in Melville, NY
• Providers in Melville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.