Individual provider Active NPI

Stephanie Rodriguez Wollman, ANP-C

  • Adult Health Nurse Practitioner
  • Livingston, NJ
National Provider Identifier
1033547427
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00059500 Issued in NJ
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(973) 322-6450
NPI assigned
Oct 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00059500 NJ Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

53 Hunter Ave
Fanwood, NJ 07023-1246
Phone (908) 490-1113

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318000780 NJ Practitioner - Nurse Practitioner 3678870615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

375 Mount Pleasant Ave
West Orange, NJ 07052-2750
Phone (973) 731-9442

94 Old Short Hills Rd
Livingston, NJ 07039-5672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00059500NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Jan 19, 2016 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Jan 19, 2016 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

1351 Old Freehold Rd
Toms River, NJ 08753
Phone (732) 240-0090

95 Old Short Hills Rd
West Orange, NJ 07052
Phone (973) 322-4800

375 Mount Pleasant Ave
Ste 102
West Orange, NJ 07052

324 South Ave E
Westfield, NJ 07090
Phone (908) 232-2727

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1033547427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 HUNTER AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231246",
            "telephone_number": "908-490-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLMAN",
        "first_name": "STEPHANIE",
        "middle_name": "RODRIGUEZ",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00059500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.