Individual provider Active NPI

Ranju B Wadhwa, M.D.

  • Rheumatology Physician
  • Port St Lucie, FL
National Provider Identifier
1659327419
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME 63650 Issued in FL
Practice address
1701 SE Hillmoor Dr
D-16
Port St Lucie, FL 34952-7552
Phone
(772) 800-7758
Fax
(772) 800-7867
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X ME 63650 FL Primary

Addresses

Primary practice location

1701 SE Hillmoor Dr
D-16
Port St Lucie, FL 34952-7552

Mailing address

1701 SE Hillmoor Dr
D-16
Port St Lucie, FL 34952-7552
Phone (772) 800-7758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, SD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080502000523 FL Practitioner - RheumatologyPractitioner - Internal Medicine 5193804078 Reassigns benefits to 1 organization
I20170209000167 TX Practitioner - Internal Medicine 5193804078 Reassigns benefits to 1 organization
I20170905003424 SD Practitioner - Rheumatology 5193804078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1701 SE Hillmoor Dr
Suite D16
Port St Lucie, FL 34952-7541
Phone (772) 800-7758

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 63650FLMDRheumatology Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
Kayenta Alternative Rural Hospital CurrentSince Dec 19, 2016 Accepting new patients
Arthritis and Rheumatology Associates of Treasure Coast LLC Rheumatology CurrentSince Jan 25, 2017 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Jul 13, 2017 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. Family Medicine CurrentSince Jul 13, 2017 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients

Locations

1701 SE Hillmoor Dr
Ste D16
Port St Lucie, FL 34952
Phone (772) 210-1162

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 6

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 2

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1659327419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR",
            "address_2": "D-16",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527552",
            "telephone_number": "772-800-7758",
            "fax_number": "772-800-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR",
            "address_2": "D-16",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527552",
            "telephone_number": "772-800-7758",
            "fax_number": "772-800-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHWA",
        "first_name": "RANJU",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME 63650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.