Individual provider Active NPI

Charudatta Wankhade, MD

  • Gastroenterology Physician
  • Neptune, NJ
National Provider Identifier
1104202175
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA12603900 Issued in NJ
Practice address
19 Davis Ave FL 6
Neptune, NJ 07753-4488
Phone
(732) 897-2777
Fax
(732) 897-3970
NPI assigned
Jul 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0091132 MD
Gastroenterology Physician 207RG0100X 25MA12603900 NJ Primary

Addresses

Primary practice location

19 Davis Ave FL 6
Neptune, NJ 07753-4488

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210510000013 MD Practitioner - Gastroenterology 0749527398 Reassigns benefits to 1 organization
I20221116003033 DC Practitioner - GastroenterologyPractitioner - Internal Medicine 0749527398 Reassigns benefits to 1 organization
I20250710002110 NJ Practitioner - Gastroenterology 0749527398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

19 Davis Ave
FL 6
Neptune, NJ 07753-4488
Phone (732) 897-3995

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
61.45
Promoting interoperability
96
Improvement activities
40
Cost
79.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Upper gastrointestinal (GI) endoscopy for acid reflux19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0091132MDMDGastroenterology Physician
25MA12603900NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2024 Accepting new patients
Medstar Medical Group - Southern Maryland LLC Current Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4660 Wilkens Ave
Ste 100
Baltimore, MD 21229
Phone (410) 247-0782

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

24035 Three Notch Rd
Hollywood, MD 20636
Phone (301) 373-2588

23511 Hollywood Rd
Ste 2
Leonardtown, MD 20650
Phone (301) 997-0611

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

19 Davis Ave
Fl 6
Neptune, NJ 07753
Phone (732) 897-3990

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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 5

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": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1104202175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE FL 6",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-897-2777",
            "fax_number": "732-897-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24035 Three Notch Rd",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "MD",
            "postal_code": "206364871",
            "country_code": "US",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANKHADE",
        "first_name": "CHARUDATTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-31",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0091132",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA12603900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.