Edison Wellness Medical Group PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDISON WELLNESS MEDICAL GROUP PA

Practice address

2 Ethel Rd
Suite 203C
Edison, NJ 08817-2839

Phone

(732) 662-1100

Fax

(732) 662-1153

NPI assigned

May 11, 2017

Last updated

May 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hao ZhangNPI 1568732527

Title

President/Provider

Phone

(732) 662-1100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hao Zhang, MD

  • Internal Medicine Physician
  • Edison, NJ
  • NPI 1568732527
  Medicare reassignment NPD Authorized official
• Ann Larraine Madera, OTR/L

  • Occupational Therapist
  • New Brunswick, NJ
  • NPI 1699141564
  NPD (past)
• Krishna Patel, DPT

  • Physical Therapist
  • Piscataway, NJ
  • NPI 1447661517
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1417483314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ETHEL RD",
            "address_2": "SUITE 203C",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172839",
            "telephone_number": "732-662-1100",
            "fax_number": "732-662-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ETHEL RD",
            "address_2": "SUITE 203C",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172839",
            "telephone_number": "732-662-1100",
            "fax_number": "732-662-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON WELLNESS MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "ZHANG",
        "authorized_official_first_name": "HAO",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "732-662-1100"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edison Surgery Center LLC
• Edison Surgical Center, L.L.C.
• Edison Township Board of Education
• Edison Urgent Care Inc
• Edison Wellness Holistic Center PC
• Edison-Clark Oral Surgery Associates
• Robert Edmonds, ATCL
• Jernier Edwards
• Keisha Edwards, MA, SLPD CCC-SLP
• Morton Eidelberg, RPH

• Internal Medicine Physician in Edison, NJ
• Providers in Edison, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.