Jason B. Wynberg, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA10611400 Issued in NJ

Practice address

718 Teaneck Rd
Teaneck, NJ 07666-4245

Phone

(201) 227-6008

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwynberg10024@njurology.direct-ci.com
• Direct secure messaging: jwynberg@nj-urology.gwaydirect.com

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.

• Excelcare Medical Associates, PA

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1992736300
  Medicare reassignment Care Compare group NPD
• DMC Orthopedic Billing Associates LLC

  • Orthopaedic Surgery Physician
  • Detroit, MI
  • NPI 1457387607
  NPD (past)
• LMC Physician Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346256104

  Urology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1023090230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3599",
            "fax_number": "201-227-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-227-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNBERG",
        "first_name": "JASON",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301086135",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "BW9323382",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "240026",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA10611400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02759039",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1388005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Women'S League Community Residences, Inc.
• Jiyoung Wong, D.O
• Robert T Wong, D.M.D.
• Robert Worth, MD
• Maria Wunsch
• Yakov Yakubov
• Rena Yalen, MSW, LCSW
• Michael David Yammer, PH.D.
• Brian J Yang
• Paula A. Yapor Valentin, MD

• Urology Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.