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DR. WILLIAM WERTHEIM M.D.
NPI 1174548200
Internal Medicine in East Setauket, NY

Active since July 12, 2006PECOS EnrolledAccepts Medicare Assignment
98.52/100
CMS Quality Rating
205 N BELLE MEAD RD, EAST SETAUKET, NY 11733(631) 444-4630 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. William Wertheim M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM WERTHEIM M.D. (NPI 1174548200) is an individual internal medicine provider in East Setauket, New York, licensed in New York (196934) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of New York University School Of Medicine (1989).

NPPES Registry Identity

NPI1174548200
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. WILLIAM WERTHEIMCredential: M.D.
Location Address205 N BELLE MEAD RDEast Setauket, NY 11733
Mailing AddressP.o. Box 1559Stony Brook, NY 11790
Phone(631) 444-4630
Sole ProprietorNo
Medical School CMSNew York University School Of MedicineGraduated 1989
Enumeration DateJuly 12, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174548200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 196934
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
205 N BELLE MEAD RD, East Setauket, NY 11733
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Other Identifiers 5

Other33J362NY · Empire Bc.bs
Medicaid01506798NY
Other4566182NY · Aetna
Medicare UPINF19380NY
Medicare ID-Type Unspecified33J361NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. William Wertheim M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062547912
PECOS Enrollment IDI20100317000127
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
130 services88 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
36 services27 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
18 services18 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
18 services17 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11733 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.85
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers19 claims53 services$6.13 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MELISSA LECTURA MD
Family Medicine (Geriatric Medicine)
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630
LIDIA VALJAN
Nurse Practitioner (Primary Care)
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630
DR. KERIM ODEKON MD
Internal Medicine
205 N BELLE MEAD RD
SETAUKET, NY 11733
Suffolk County (631) 444-4630
RITA MARIE KELLY NP
Nurse Practitioner (Adult Health)
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4795
DR. LISA STRANO-PAUL M.D.
Internal Medicine
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630
DR. KIMBERLY ANN KRANZ M.D.
Internal Medicine
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630
TRACEY L SPINNATO MD
Internal Medicine
205 N BELLE MEAD RD, STONY BROOK PRIMARY CARE CENTER
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630
BIBI N ZAINUL MD
Internal Medicine
205 N BELLE MEAD RD
EAST SETAUKET, NY 11733
Suffolk County (631) 444-4630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Wertheim's NPI number?

The NPI number for William Wertheim is 1174548200. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is William Wertheim located?

William Wertheim practices at 205 N Belle Mead Rd, East Setauket, NY 11733. The listed phone number is (631) 444-4630.

What is William Wertheim's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is William Wertheim enrolled in Medicare?

Yes. William Wertheim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is William Wertheim affiliated with any hospitals?

According to CMS data, William Wertheim is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for William Wertheim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.