Individual provider Active NPI

Adrienne Randy Wasserman, MD

  • Emergency Medicine Physician
  • Paramus, NJ
National Provider Identifier
1366463788
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA10719400 Issued in NJ
Practice address
282 E Rte 4
Paramus, NJ 07652-5101
Phone
(551) 222-0800
Fax
(551) 222-0801
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2380761 NY
Emergency Medicine Physician 207P00000X 25MA10719400 NJ Primary

Addresses

Primary practice location

282 E Rte 4
Paramus, NJ 07652-5101

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060908000339 NY Practitioner - Emergency Medicine 5698779445 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10719400NJMDEmergency Medicine Physician
2380761NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian/Queens Emergency Medicine CurrentSince Oct 27, 2009 Accepting new patients
Montefiore Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Montefiore Medical Center Emergency Medicine CurrentSince Jan 13, 2024 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine Current Accepting new patients
Newyork-Presbyterian-Queens CurrentSince Oct 27, 2009 Accepting new patients
Michael S Lippe MD, PC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

111 E 210th St
Bronx, NY 10467

17561 Hillside Ave
Ste 402
Jamaica, NY 11432
Phone (718) 670-1021

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

Networks

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

Interoperability endpoints

  • Direct secure messaging: adwasserma@montefioredirect.com

Organizations & group practices 7

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 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1366463788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 E RTE 4",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525101",
            "telephone_number": "551-222-0800",
            "fax_number": "551-222-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "ADRIENNE",
        "middle_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "2380761",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10719400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.