Janette M Wahba, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

25MA03093400 Issued in NJ

Practice address

525 Ridge Rd
Lyndhurst, NJ 07071-2739

Phone

(201) 935-5512

Fax

(201) 935-1914

NPI assigned

Mar 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paterson Division of HealthGroup PAC ID 0446280663, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Paterson Division of Health

  • Public Health or Welfare Agency
  • Paterson, NJ
  • NPI 1801001300
  Medicare reassignment Care Compare group NPD
• Paterson Division of Health

  • State or Local Public Health Clinic/Center
  • Paterson, NJ
  • NPI 1306808373
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1659331114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070712739",
            "telephone_number": "201-935-5512",
            "fax_number": "201-935-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070712739",
            "telephone_number": "201-935-5512",
            "fax_number": "201-935-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHBA",
        "first_name": "JANETTE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA03093400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1879308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Andrew Velardi, DDS
• Valerie Ann Ventura LPC, MS/ LPC
• Michelle Vieira, BCBA
• Voice & Value Psychotherapy PC
• Soheila Vossough, M.D.
• Walgreen Co (Walgreens #18389)
• Zisalo Wancier, M.D.
• Tevin Weems
• Tashia Williams, DNP
• Omar Wilson

• Pediatric Adolescent Medicine Physician in Lyndhurst, NJ
• Providers in Lyndhurst, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.