Wanda Ivette Lopez-Rodriguez, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00325900 Issued in NJ

Practice address

1105 Route 46
Ledgewood, NJ 07852

Phone

(973) 927-4662

Fax

(973) 927-4668

NPI assigned

Jan 11, 2011

Last updated

Jul 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of New Jersey LLCGroup PAC ID 8527142439, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minuteclinic Diagnostic of New Jersey LLC

  • Family Nurse Practitioner
  • Sewell, NJ
  • NPI 1053353615
  Medicare reassignment Care Compare group
• Minuteclinic Primary Care New Jersey LLC

  • Family Nurse Practitioner
  • Sewell, NJ
  • NPI 1174331524
  Medicare reassignment NPD

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1194020834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MOUNT OLIVE RD",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369725",
            "telephone_number": "973-527-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 ROUTE 46",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "07852",
            "telephone_number": "973-927-4662",
            "fax_number": "973-927-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-RODRIGUEZ",
        "first_name": "WANDA",
        "middle_name": "IVETTE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00325900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION NUMBER",
            "identifier": "F0910124",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Karnitsky, D.C.
• Mariya Khalaboura, DPT
• Eileen Krahling, APN
• Nicole Marie Lacherza-Drew, PSYD
• Leonard J. Grossman. MD (Pediatric & Adolescent Ctr)
• Srinivas Maddali
• Shannon Barbara Maher, FNP-C
• Sana Mandal
• Maximum Health & Wellness Florham Park, LLC
• Corri May

• Family Nurse Practitioner in Ledgewood, NJ
• Providers in Ledgewood, 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 Jul 11, 2016; 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.