Individual provider Active NPI

Lewis Wetstein, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Freehold, NJ
National Provider Identifier
1790774230
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MA37576 Issued in NJ
Practice address
143 South St
Freehold, NJ 07728-2043
Phone
(732) 780-9270
Fax
(732) 780-2107
NPI assigned
Oct 18, 2005
Last updated
Jun 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MA37576 NJ Primary

Addresses

Primary practice location

143 South St
Freehold, NJ 07728-2043

Mailing address

143 South St
Freehold, NJ 07728-2043
Phone (732) 780-9270

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
I20051019000700 NJ Practitioner - Thoracic Surgery 3971529983

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA37576NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Organizations & group practices 1

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1790774230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SOUTH ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282043",
            "telephone_number": "732-780-9270",
            "fax_number": "732-780-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SOUTH ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282043",
            "telephone_number": "732-780-9270",
            "fax_number": "732-780-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETSTEIN",
        "first_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "MA37576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.