Konstantin Walmsley, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA07775300 Issued in NJ

Practice address

311 Bay Ave Ste 200
Glen Ridge, NJ 07028-1621

Phone

(973) 429-0462

Fax

(973) 429-8765

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 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

Urology

Education

Vanderbilt University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054
• Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009
• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
• Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwalmsley10018@njurology.direct-ci.com
• Direct secure messaging: kwalmsley@nj-urology.gwaydirect.com
• Direct secure messaging: konstantin.walmsley.1@5580.direct.athenahealth.com
• Direct secure messaging: kwalmsley191626@ahs.direct-ci.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• New Jersey Urology LLC

  • Urology Physician
  • Bloomfield, NJ
  • NPI 1588822423
  Medicare reassignment NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clara Maass Medical Center

  • General Acute Care Hospital
  • Belleville, NJ
  • NPI 1902901333
  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation
• Kessler Institute for Rehabilitation Inc

  • Rehabilitation Hospital
  • West Orange, NJ
  • NPI 1013919620

  Inpatient rehabilitation facility

  Care Compare affiliation
• Montclair Hospital LLC

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1730156456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 BAY AVE STE 200",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281621",
            "telephone_number": "973-429-0462",
            "fax_number": "973-429-8765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "799 Bloomfield Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441301",
            "country_code": "US",
            "telephone_number": "973-429-0462",
            "fax_number": "973-429-8765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALMSLEY",
        "first_name": "KONSTANTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA07775300",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA07775300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039942",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwalmsley10018@njurology.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "New Jersey Urology LLC",
            "address_1": "1515 Broad St",
            "address_2": "Suite B130",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Valerian, D.O.
• Vernonway Healthcare Agency
• John Salvatore Voltarelli, MA
• Foram Vyas, PHARMD
• Lois Jean Waldman, MA
• Francis E Wanat, MD
• Stacey Lynne Wanat, PT, DPT
• Barry J Weber, M.D.
• Aaron Jase Whipple
• Will'S Power LLC

• Urology Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.