Individual provider Active NPI

Wendy T Shertz-Dipietro, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Long Branch, NJ
National Provider Identifier
1518028307
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA04831900 Issued in NJ
Practice address
300 Second Avenue
Monmouth Medical Center Dept of Pathology
Long Branch, NJ 07740
Phone
(732) 229-8711
Fax
(732) 229-0245
NPI assigned
Dec 13, 2006
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA04831900 NJ Primary

Addresses

Primary practice location

300 Second Avenue
Monmouth Medical Center Dept of Pathology
Long Branch, NJ 07740

Mailing address

PO Box 417
279 Third Avenue Suite 104
Long Branch, NJ 07740
Phone (732) 229-8711

Other identifiers 1

IdentifierTypeStateIssuer
2309602MedicaidNJ

Other names 1

  • Wendy Dipietro Other name

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
I20101122000046 NJ Practitioner - Pathology 1153517891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Hahnemann University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
Rutgers Health RWJ Pathology
New Brunswick, NJ 08901-1928
Phone (732) 937-8651

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04831900NJMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Laboratory Medicine Associates Past Accepting new patients

Locations

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

66 W Gilbert St
Ste 2
Tinton Falls, NJ 07701
Phone (732) 212-0051

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1518028307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "address_2": "279 THIRD AVENUE SUITE 104",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "07740",
            "telephone_number": "732-229-8711",
            "fax_number": "732-229-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SECOND AVENUE",
            "address_2": "MONMOUTH MEDICAL CENTER DEPT OF PATHOLOGY",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "07740",
            "telephone_number": "732-229-8711",
            "fax_number": "732-229-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERTZ-DIPIETRO",
        "first_name": "WENDY",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA04831900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2309602",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "DIPIETRO",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.