Denise Lynn Wunderler, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

25MB10009200 Issued in NJ

Practice address

4251 US 9 Ste B
Freehold, NJ 07728-8304

Phone

(732) 683-1800

NPI assigned

Apr 10, 2007

Last updated

Feb 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Central Jersey Spine & Wellness L L C

  • Chiropractor
  • Freehold, NJ
  • NPI 1215123641
  Medicare reassignment NPD
• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Medassist USA LLC

  • Case Management Agency
  • Lakewood, NJ
  • NPI 1982211439
  NPD
• Lake Hospital System

  • Obstetrics & Gynecology Physician
  • Willoughby, OH
  • NPI 1346202512
  NPD (past)
• Lake Hospital System Inc

  dba Lake Health Allied Health Professionals

  • Physician Assistant
  • Concord TWP, OH
  • NPI 1851698435
  NPD (past)
• Lake Hospital System Inc.

  • Adult Health Nurse Practitioner
  • Concord TWP, OH
  • NPI 1043275837
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1669695425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 US 9 STE B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288304",
            "telephone_number": "732-683-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 US 9 STE B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288304",
            "telephone_number": "732-683-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLER",
        "first_name": "DENISE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MB10009200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-SJC",
            "identifier": "P00817789",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669695425",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Wright, M.A., BCBA
• Kimberly Wright, RN,MSN
• Samantia N Wright, NP-C
• Stephanie Wright, LAC
• Beth Wrublevski, BCBA
• Keith Wyche
• Meredith Wymer, APN
• Diane Yacono, NP
• Yafa Walkin DDS of Freehold SPC
• Yale Perinatal Associates, LLC

• Sports Medicine (Family Medicine) Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Sports Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.