Individual provider Active NPI

Kurt Richard Wengerter, MD

  • Vascular Surgery Physician
  • Englewood, NJ
National Provider Identifier
1265491880
Registry record updated Mar 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MA06395000 Issued in NJ
Practice address
25 Rockwood PL
Suite 330
Englewood, NJ 07631-4957
Phone
(201) 408-5195
Fax
(201) 408-2485
NPI assigned
Mar 22, 2006
Last updated
Mar 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA06395000 NJ
Vascular Surgery Physician 2086S0129X 25MA06395000 NJ Primary

Addresses

Primary practice location

25 Rockwood PL
Suite 330
Englewood, NJ 07631-4957

Mailing address

25 Rockwood PL
Suite 330
Englewood, NJ 07631-4957
Phone (201) 408-5195

Other identifiers 3

IdentifierTypeStateIssuer
01026099MedicaidNY
020034631OtherNJRAILROAD MEDICARE ID #
6984100MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050726000454 NJ Practitioner - Vascular Surgery 3476580077 Reassigns benefits to 1 organization
I20161130001160 NY Practitioner - Vascular Surgery 3476580077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergen Thoracic and Vascular Associates PCGroup PAC ID 0042440174, 3 clinicians
Rockland Thoracic and Vascular Associates, P.C.Group PAC ID 8325936479, 10 clinicians

Practice addresses (Care Compare)

25 Rockwood PL
Suite 330
Englewood, NJ 07631-4958
Phone (201) 405-5195

350 Engle St
Berrie BLDG Suite 6586
Englewood, NJ 07631-1808
Phone (201) 408-5195

5 A Medical Park Dr
Pomona, NY 10970-3516
Phone (845) 362-1081

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.41 of 100Reported as group
Quality
41.6
Improvement activities
40
Cost
62.56

Merit-based Incentive Payment System (MIPS)

Final score
78.07 of 100Reported as group
Quality
45.39
Improvement activities
40
Cost
77.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Removal of tissue43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06395000NJMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen Thoracic and Vascular Associates P.C. Vascular Surgery CurrentSince Nov 1, 2016 Accepting new patients
Hudson Valley Thoracic & Vascular Assoc. PLLC Vascular Surgery CurrentSince Nov 1, 2016 Accepting new patients
Rockland Thoracic & Vascular Associates, P.C. CurrentSince Dec 1, 2016 Accepting new patients

Locations

25 Rockwood Pl
Ste 330
Englewood, NJ 07631
Phone (201) 405-5195

350 Engle St
Ste 65
Englewood, NJ 07631
Phone (201) 408-5195

70 Hatfield Ln
Ste 202
Goshen, NY 10924
Phone (845) 291-3656

5A Medical Park Dr
Pomona, NY 10970
Phone (845) 362-0075

Networks

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

Organizations & group practices 3

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.

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489276800000",
    "number": "1265491880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "address_2": "SUITE 330",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-408-5195",
            "fax_number": "201-408-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "address_2": "SUITE 330",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-408-5195",
            "fax_number": "201-408-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGERTER",
        "first_name": "KURT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2017-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA06395000",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA06395000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01026099",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID #",
            "identifier": "020034631",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6984100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.