NPIMap

Individual provider Active NPI

Mitchell Wangsgard, M.D.

  • Diagnostic Radiology Physician
  • Livingston, NJ
National Provider Identifier
1770978819
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101271478 Issued in VA
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(973) 322-8945
Fax
(973) 322-2471
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 0101271478 VA Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

94 Old Short Hills Rd
Dept of Radiology
Livingston, NJ 07039-5672
Phone (973) 322-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611000210 VA Practitioner - Diagnostic Radiology 9234430091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Radiologists IncGroup PAC ID 5395640650, 124 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 668-3231

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101271478VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Advanced Imaging Solutions, LLC Diagnostic Radiology CurrentSince Mar 26, 2021 Accepting new patients
Medical Center Radiologists Inc Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients

Locations

600 Gresham Dr
Ste 700
Norfolk, VA 23507
Phone (757) 388-1700

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

800 Independence Blvd
Virginia Beach, VA 23455
Phone (757) 363-6100

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1770978819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-8945",
            "fax_number": "973-322-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGSGARD",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101271478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.