Individual provider Active NPI

Shoshana Gabriele Weiser, PA-C

  • Physician Assistant
  • Flushing, NY
National Provider Identifier
1972176550
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14744 71St Rd # B
Flushing, NY 11367-2011
Phone
(267) 290-6764
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

14744 71St Rd # B
Flushing, NY 11367-2011

Mailing address

14744 71St Rd # B
Flushing, NY 11367-2011
Phone (267) 290-6764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027097-01NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1972176550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14744 71ST RD # B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672011",
            "telephone_number": "267-290-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14744 71ST RD # B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672011",
            "telephone_number": "267-290-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISER",
        "first_name": "SHOSHANA",
        "middle_name": "GABRIELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.