Individual provider Active NPI

Wilfredo Carreno, MD

  • Cardiovascular Disease Physician
  • Galloway, NJ
National Provider Identifier
1700803582
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA03522800 Issued in NJ
Practice address
318 Chris Gaupp Dr
Galloway, NJ 08205-4460
Phone
(609) 404-9900
Fax
(609) 404-3653
NPI assigned
Jul 16, 2006
Last updated
Aug 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA03522800 NJ Primary

Addresses

Primary practice location

318 Chris Gaupp Dr
Galloway, NJ 08205-4460

Mailing address

318 Chris Gaupp Dr
Galloway, NJ 08205-4460
Phone (609) 404-9900

Other identifiers 4

IdentifierTypeStateIssuer
P655280OtherNJOXFORD
113835OtherNJAETNA
0099969000OtherNJAMERIHEALTH
6521935005OtherNJCIGNA

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
I20040806000016 NJ Practitioner - Cardiovascular Disease (Cardiology) 4082528179 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Cardiovascular Disease CurrentSince Oct 26, 2018 Accepting new patients
SMH Cardiology LLC PastSince Oct 1, 2001 Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

106 Court House South Dennis Rd
Ste 200
Cape May Court House, NJ 08210
Phone (609) 465-0300

318 Chris Gaupp Dr
Galloway, NJ 08205
Phone (609) 404-9900

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1700803582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 CHRIS GAUPP DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054460",
            "telephone_number": "609-404-9900",
            "fax_number": "609-404-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 CHRIS GAUPP DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054460",
            "telephone_number": "609-404-9900",
            "fax_number": "609-404-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRENO",
        "first_name": "WILFREDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA03522800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P655280",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "113835",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0099969000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6521935005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.