Individual provider Active NPI

Peter N. Wenger, M.D.

  • Pediatric Infectious Diseases Physician
  • Newark, NJ
National Provider Identifier
1396759429
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
25MA06134800 Issued in NJ
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-0741
Fax
(973) 972-7597
NPI assigned
Jul 27, 2006
Last updated
Aug 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 25MA06134800 NJ Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
6613802MedicaidNJ

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
I20140507000269 NJ Practitioner - Pediatric MedicinePractitioner - Infectious Disease 2466685086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Infectious Disease
Education
Rutgers New Jersey Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Sep 1, 2020 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Sep 1, 2020 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

Interoperability endpoints

  • Direct secure messaging: pwenger60551@epicdirect.rwjbh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1396759429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-0741",
            "fax_number": "973-972-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "PETER",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NJ",
            "license": "25MA06134800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6613802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.