Individual provider Active NPI

Wedad S Michael, M.D.

  • Internal Medicine Physician
  • Galloway, NJ
National Provider Identifier
1326137407
Registry record updated Oct 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05942900 Issued in NJ
Practice address
54 W Jimmie Leeds Rd Ste 14
Galloway, NJ 08205-9438
Phone
(609) 677-5777
Fax
(609) 677-1711
NPI assigned
Oct 12, 2006
Last updated
Oct 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05942900 NJ Primary

Addresses

Primary practice location

54 W Jimmie Leeds Rd Ste 14
Galloway, NJ 08205-9438

Mailing address

4 E Royal Ave
Linwood, NJ 08221-2157
Phone (609) 601-0779

Other identifiers 1

IdentifierTypeStateIssuer
6425305MedicaidNJ

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
I20050926000359 NJ Practitioner - Internal Medicine 0749214062 Practice locations: Galloway, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

54 W Jimmie Leeds Rd
Suite 14
Galloway, NJ 08205-9438
Phone (609) 677-5777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05942900NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Regional Medical Center Past Accepting new patients
Somers Medical Care, LLC PastSince Feb 1, 1999 Accepting new patients

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, 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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635033600000",
    "number": "1326137407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 E ROYAL AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082212157",
            "telephone_number": "609-601-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W JIMMIE LEEDS RD STE 14",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059438",
            "telephone_number": "609-677-5777",
            "fax_number": "609-677-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "WEDAD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-10-24",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05942900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6425305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.