Individual provider Active NPI

Wendy Rabbenou

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1225442379
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
304778 Issued in NY
Practice address
111 E. 210 Street
New York, NY 10467
Phone
(718) 920-4321
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 304778 NY Primary

Addresses

Primary practice location

111 E. 210 Street
New York, NY 10467

Mailing address

111 E. 210 Street
New York, NY 10467

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011001084 NJ Practitioner - Gastroenterology 0042618712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Albert Einstein College of Medicine of Yeshiva University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

33 Overlook Rd
Summit, NJ 07901-3570
Phone (908) 522-5040

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy40
Upper gastrointestinal (GI) endoscopy for acid reflux52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Aug 23, 2021 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

33 Overlook Rd
Ste 201
Summit, NJ 07901
Phone (908) 522-4555

Interoperability endpoints

  • Direct secure messaging: wrabbenou412971@direct.ahsys.org
  • Direct secure messaging: wrabbenou844213@nychhc.direct-ci.com

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.

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1225442379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E. 210 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E. 210 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABBENOU",
        "first_name": "WENDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "304778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.