Individual provider Active NPI

Paul H Wichman, MD

  • Internal Medicine Physician
  • Netcong, NJ
National Provider Identifier
1760534879
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA039719 Issued in NJ
Practice address
39 Maple Avenue
Netcong, NJ 07857
Phone
(973) 347-4121
Fax
(973) 347-1545
NPI assigned
Jan 17, 2007
Last updated
Sep 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA039719 NJ Primary

Addresses

Primary practice location

39 Maple Avenue
Netcong, NJ 07857

Mailing address

39 Maple Avenue
Netcong, NJ 07857
Phone (973) 347-4121

Other identifiers 1

IdentifierTypeStateIssuer
1917102MedicaidNJ

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
I20100928001281 NJ Practitioner - Internal Medicine 6800912767 Practice locations: Netcong, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

39 Maple Ave
Netcong, NJ 07857-1105
Phone (973) 347-4121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA039719NJMDInternal Medicine Physician

Hospital & facility affiliations 5

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1760534879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MAPLE AVENUE",
            "city": "NETCONG",
            "state": "NJ",
            "postal_code": "07857",
            "telephone_number": "973-347-4121",
            "fax_number": "973-347-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 MAPLE AVENUE",
            "city": "NETCONG",
            "state": "NJ",
            "postal_code": "07857",
            "telephone_number": "973-347-4121",
            "fax_number": "973-347-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMAN",
        "first_name": "PAUL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA039719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1917102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Netcong, NJ

Sources for this page

Verify at the official NPI Registry.