Kelly Vanwyck

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00792600 Issued in NJ

Practice address

477 Route 10 Ste 205
Randolph, NJ 07869-2144

Phone

(973) 560-9500

NPI assigned

Jan 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
• Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
• Direct secure messaging: kelly.van.wyck.1@25493.direct.athenahealth.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.

• Vanguard Medical Group, PA

  • Family Medicine Physician
  • Verona, NJ
  • NPI 1073674412
  Medicare reassignment Care Compare group NPD
• Primary Care for the Homebound PA

  • Home Health Agency
  • Verona, NJ
  • NPI 1609206671
  NPD

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

• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation
• Prime Healthcare Services - Saint Clare'S LLC

  • General Acute Care Hospital
  • Denville, NJ
  • NPI 1598144362
  Care Compare affiliation

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1104334655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ROUTE 46 E STE 450",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041583",
            "telephone_number": "973-559-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 ROUTE 10 STE 205",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692144",
            "telephone_number": "973-560-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWYCK",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00792600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Turner, DVM
• Damanpreet Ubhi, MD, BS
• Jaclyn Lauren Vairo, LPC
• Melanie Rouse Valentin-Torres, M.D.
• Mary Vanecek
• Raghunandan Medavaram Varma, DO
• Michael Victor Venanzi, MD
• Luz Ventura-Polanco
• Vesur LLC
• Mario S Viegas

• Family Nurse Practitioner in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.