Individual provider Active NPI

Wamidh Tellow, MD

  • Family Medicine Physician
  • Linden, NJ
National Provider Identifier
1235717042
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12372700 Issued in NJ
Practice address
328 W Saint Georges Ave
Linden, NJ 07036-5638
Phone
(908) 925-7519
Fax
(908) 925-2842
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA12372700 NJ Primary

Addresses

Primary practice location

328 W Saint Georges Ave
Linden, NJ 07036-5638

Mailing address

1400 South Ave # 1-429
Plainfield, NJ 07062-1964

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-4600

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
I20250114002136 NJ Practitioner - Family Practice 3870995988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

328 W Saint Georges Ave
Linden, NJ 07036-5638

456 Prospect Ave
West Orange, NJ 07052-4112
Phone (973) 731-6767

90 Route 22
Springfield, NJ 07081-3110
Phone (973) 467-2273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12372700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Wood Johnson Medical Associates at Hamilton PA CurrentSince Nov 4, 2024 Accepting new patients
Robert Wood Johnson Medical Associates at Hamilton PA Family Medicine CurrentSince Nov 4, 2024 Accepting new patients

Locations

328 W Saint Georges Ave
Linden, NJ 07036
Phone (608) 925-2273

90 US Highway 22 W
Springfield, NJ 07081
Phone (973) 467-0963

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1235717042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SOUTH AVE # 1-429",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070621964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W SAINT GEORGES AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070365638",
            "telephone_number": "908-925-7519",
            "fax_number": "908-925-2842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLOW",
        "first_name": "WAMIDH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12372700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NJ

Sources for this page

Verify at the official NPI Registry.