Individual provider Active NPI

Kenneth Wu, MD

  • Physical Medicine & Rehabilitation Physician
  • Cherry Hill, NJ
National Provider Identifier
1275565392
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA06591200 Issued in NJ
Practice address
15 Versailles Blvd
Cherry Hill, NJ 08003-5133
Phone
(732) 281-3590
Fax
(732) 281-0054
NPI assigned
Jul 7, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA06591200 NJ Primary

Addresses

Primary practice location

15 Versailles Blvd
Cherry Hill, NJ 08003-5133

Mailing address

PO Box 1304
Cherry Hill, NJ 08034-0039
Phone (732) 281-3590

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
I20070510000573 NJ Practitioner - Physical Medicine and Rehabilitation 1658477401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Perelman School of Med at the University of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

92 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 988-4214

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
KW Rehab LLC Physical Medicine & Rehabilitation CurrentSince Jan 1, 2006 Accepting new patients
Cooper Physical Medicine & Rehabilitation Associates, PC PastSince Aug 7, 2006 Accepting new patients
Kessler Institute for Rehabilitation, Inc. Past Accepting new patients
CMC Psychiatric Associates, PC Past Accepting new patients

Locations

92 Brick Rd
Marlton, NJ 08053
Phone (856) 988-4124

Organizations & group practices 4

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 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275565392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080340039",
            "telephone_number": "732-281-3590",
            "fax_number": "732-281-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VERSAILLES BLVD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080035133",
            "telephone_number": "732-281-3590",
            "fax_number": "732-281-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA06591200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.