| Kenneth Weisman, MD | |
|
400 Matthew St, Suite 303, Marietta, OH 45750-1644 | |
| (740) 373-7828 | |
| (740) 373-5898 |
| Full Name | Kenneth Weisman |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 40 Years |
| Location | 400 Matthew St, Marietta, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194785642 | NPI | - | NPPES |
| 000000728272 | Other | OH | ANTHEM |
| 0052750 | Medicaid | OH | |
| 3810021225 | Medicaid | WV | |
| P01216329 | Other | OH | RAILROAD MEDICARE |
| 000000727239 | Other | OH | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 47702 (Connecticut) | Secondary |
| 208800000X | Urology | 35.097897 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Charlotte Hungerford Hospital | Torrington, CT | Hospital |
| The Hospital Of Central Connecticut | New britain, CT | Hospital |
| Midstate Medical Center | Meriden, CT | Hospital |
| Sharon Hospital | Sharon, CT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hartford Healthcare Medical Group Specialists Pllc | 3173866241 | 1329 |
| The Charlotte Hungerford Hospital | 4486557501 | 178 |
| Entity Name | The Charlotte Hungerford Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629075734 PECOS PAC ID: 4486557501 Enrollment ID: O20040128000183 |
| Entity Name | Hartford Healthcare Medical Group Specialists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023584216 PECOS PAC ID: 3173866241 Enrollment ID: O20190514001441 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Weisman, MD 201 N Mountain Rd, Plainville, CT 06062-1848 Ph: (740) 374-4500 | Kenneth Weisman, MD 400 Matthew St, Suite 303, Marietta, OH 45750-1644 Ph: (740) 373-7828 |
Carson Wong, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Matthew St Ste 303, Marietta, OH 45750 Phone: 740-373-7828 Fax: 740-373-5898 |