Active NPI
Wayne R Braendle, MD
- Internal Medicine Physician
- Red Bank, NJ
National Provider Identifier
1225010374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Practice address
- 370 Highway 35
Ste 200
Red Bank, NJ 07701-5922 - Phone
- (732) 936-1095
- Fax
- (732) 936-1027
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NJ | Primary |
Addresses
Primary practice location
370 Highway 35
Ste 200
Red Bank, NJ 07701-5922
Mailing address
PO Box 8519
Red Bank, NJ 07701-8519
Phone (732) 460-9840
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0036507 | Other | AETNA HEALTH HMO | |
| 1911201 | Medicaid | NJ | |
| 0K4743 | Other | HEALTH NET OF THE NE INC | |
| 4379743 | Other | AETNA HEALTH TRADITIONAL | |
| 6102397 | Other | NJ | CIGNA HEALTHCARE OF NJ |
| 82A102 | Other | NJ | WELLCHOICE HMO OF NJ |
| 82A101 | Other | NY | EMPIRE BC BS OF NY |
| 041081 | Other | AETNA HEALTH CAPITATION | |
| 82A101 | Other | EMPIRE HEALTHCHOICE INC | |
| 0K4743 | Other | NJ | HEALTH NET OF NJ |
| 82A102 | Other | EMPIRE HEALTH PLAN ASSUR | |
| 82A101 | Other | EMPIRE HEALTH PLAN ASSUR | |
| 82A101 | Other | NJ | WELLCHOICE INSURANCE |
| 82A101 | Other | NJ | WELLCHOICE HMO OF NJ |
| 82A102 | Other | NY | EMPIRE BC BS OF NY |
| 82A102 | Other | EMPIRE HEALTHCHOICE INC | |
| 82A102 | Other | NJ | WELLCHOICE INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA3809600 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ima Urgent Care | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Shrewsbury, NJ
- NPI 1427432244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1225010374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8519",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077018519",
"telephone_number": "732-460-9840",
"fax_number": "732-460-9848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 HIGHWAY 35",
"address_2": "STE 200",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077015922",
"telephone_number": "732-936-1095",
"fax_number": "732-936-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAENDLE",
"first_name": "WAYNE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH HMO",
"identifier": "0036507",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1911201",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET OF THE NE INC",
"identifier": "0K4743",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH TRADITIONAL",
"identifier": "4379743",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE OF NJ",
"identifier": "6102397",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCHOICE HMO OF NJ",
"identifier": "82A102",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC BS OF NY",
"identifier": "82A101",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH CAPITATION",
"identifier": "041081",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HEALTHCHOICE INC",
"identifier": "82A101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET OF NJ",
"identifier": "0K4743",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HEALTH PLAN ASSUR",
"identifier": "82A102",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HEALTH PLAN ASSUR",
"identifier": "82A101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCHOICE INSURANCE",
"identifier": "82A101",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCHOICE HMO OF NJ",
"identifier": "82A101",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC BS OF NY",
"identifier": "82A102",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HEALTHCHOICE INC",
"identifier": "82A102",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCHOICE INSURANCE",
"identifier": "82A102",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bank, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.