Individual provider Active NPI

Wylie Y Lopez, MD

  • Orthopaedic Surgery of the Spine Physician
  • Manasquan, NJ
National Provider Identifier
1447609748
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
25MA11399800 Issued in NJ
Practice address
2315 Route 34
Manasquan, NJ 08736-1444
Phone
(732) 974-0404
Fax
(732) 449-4271
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 25MA11399800 NJ
Orthopaedic Surgery of the Spine Physician 207XS0117X 25MA11399800 NJ Primary

Addresses

Primary practice location

2315 Route 34
Manasquan, NJ 08736-1444

Mailing address

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

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
I20220818002999 NJ Practitioner - Orthopedic Surgery 6901194455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rush Medical College of Rush University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

2035 Lincoln Hwy
Edison, NJ 08817-3351
Phone (732) 974-0404

226 Route 37 W
Toms River, NJ 08755-8047
Phone (732) 240-6060

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

365 Broad St
Red Bank, NJ 07701-2150
Phone (732) 933-4300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion129
Laminectomy or laminotomy (partial removal of spine bones)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11399800NJMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients
Orthonj LLC Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients

Locations

2035 Lincoln Hwy
Edison, NJ 08817
Phone (732) 974-0404

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

226 Route 37 W
Toms River, NJ 08755
Phone (732) 240-6060

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1447609748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404",
            "fax_number": "732-449-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404",
            "fax_number": "732-449-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "WYLIE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA11399800",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NJ",
            "license": "25MA11399800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

Verify at the official NPI Registry.