Physician Compare National (NPI:1942292206)

HEALTHCARE PROVIDER: MITCHELL I WEINSTEIN D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942292206
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830199850
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061221000449
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WEINSTEIN
	Individual professional last name
Provider First Name	MITCHELL
	Individual professional first name
Provider Middle Name	IRA
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GASTROENTEROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GASTROENTEROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	380 MONTAUK HWY
	Group Practice or individual's line 1 address
City	WEST ISLIP
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117954403
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330286
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GOOD SAMARITAN HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y