Individual provider Active NPI

Shira Wurzburger, NP

  • Family Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1043964125
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01264900 Issued in NJ
Practice address
103 Tudor CT
Lakewood, NJ 08701-1472
Phone
(845) 641-3463
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01264900 NJ Primary

Addresses

Primary practice location

103 Tudor CT
Lakewood, NJ 08701-1472

Mailing address

103 Tudor CT
Lakewood, NJ 08701-1472
Phone (845) 641-3463

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
I20230626000186 NJ Practitioner - Nurse Practitioner 2961860820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians

Practice addresses (Care Compare)

1352 River Ave
Lakewood, NJ 08701-5646
Phone (732) 370-5100

9 Hospital Dr
Suite A22
Toms River, NJ 08755-6425
Phone (973) 429-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01264900NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson MD Group CurrentSince Feb 9, 2023 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients

Locations

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

1352 River Ave
Lakewood, NJ 08701
Phone (732) 370-3383

784 Grand Ave
Ste 201
Ridgefield, NJ 07657
Phone (201) 346-0999

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

9 Hospital Dr
Ste A22
Toms River, NJ 08755
Phone (973) 429-1300

443 Northfield Ave
West Orange, NJ 07052
Phone (973) 324-0103

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1043964125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TUDOR CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011472",
            "telephone_number": "845-641-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 TUDOR CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011472",
            "telephone_number": "845-641-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURZBURGER",
        "first_name": "SHIRA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01264900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.