Individual provider Active NPI

Lauren Wildman, PA-C

  • Physician Assistant
  • Neptune, NJ
National Provider Identifier
1417735200
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00808600 Issued in NJ
Practice address
1945 NJ-33
Neptune, NJ 07753
Phone
(732) 775-5500
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00808600 NJ Primary

Addresses

Primary practice location

1945 NJ-33
Neptune, NJ 07753

Mailing address

51 E End Ave
Neptune City, NJ 07753-6208
Phone (201) 783-4316

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017000959 NJ Practitioner - Physician Assistant 4981059516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.04 of 100Reported as group
Quality
87.11
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Passaic River Physicians, LLC CurrentSince Sep 18, 2023 Accepting new patients
Barron Emergency Physicians LLC Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients

Locations

7600 River Rd
North Bergen, NJ 07047
Phone (201) 854-5000

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1417735200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 E END AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536208",
            "telephone_number": "201-783-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 NJ-33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-775-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDMAN",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00808600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.