Organization Active NPI

Ann Wry,MD., LLC

  • Primary Care Clinic/Center
  • Rochelle Park, NJ
National Provider Identifier
1497980734
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
25MA06650300 Issued in NJ
Legal business name
ANN WRY,MD., LLC
Practice address
114 Essex St
Rochelle Park, NJ 07662-4335
Phone
(201) 368-0201
Fax
(201) 368-0346
NPI assigned
May 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Dr. Ann M Wry, MDNPI 1013964204
Title
Owner
Phone
(201) 368-0201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 25MA06650300 NJ Primary

Addresses

Primary practice location

114 Essex St
Rochelle Park, NJ 07662-4335

Mailing address

114 Essex St
Rochelle Park, NJ 07662-4335
Phone (201) 368-0201

Other identifiers 1

IdentifierTypeStateIssuer
159767OtherNJMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100108000156 NJ Part B Supplier - Clinic/Group Practice 4789725037 Receives reassigned benefits from 1 practitioner
Practice locations: Rochelle Park, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1106798Ann Wry MD LLC114 Essex Street, 2ND Floor, Rochelle Park, NJ 07662Certificate of waiverOct 21, 2027

National Provider Directory

National Provider Directory

Locations

114 Essex St
Rochelle Park, NJ 07662
Phone (201) 368-0201

114 Essex St
Fl 2
Rochelle Park, NJ 07662

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1497980734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ESSEX ST",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624335",
            "telephone_number": "201-368-0201",
            "fax_number": "201-368-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ESSEX ST",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624335",
            "telephone_number": "201-368-0201",
            "fax_number": "201-368-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN WRY,MD., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "WRY",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-368-0201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA06650300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "159767",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.