Individual provider Active NPI

Vanessa Wejuli

  • Family Nurse Practitioner
  • Hauppauge, NY
National Provider Identifier
1811490733
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349483 Issued in NY
Practice address
960 Wheeler Rd Unit 5154
Hauppauge, NY 11788-6007
Phone
(631) 636-9018
NPI assigned
Mar 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 9716723 NY
Family Nurse Practitioner 363LF0000X 349483 NY Primary

Addresses

Primary practice location

960 Wheeler Rd Unit 5154
Hauppauge, NY 11788-6007

Mailing address

960 Wheeler Rd Unit 5154
Hauppauge, NY 11788-6007

Other identifiers 1

IdentifierTypeStateIssuer
634823245OtherNYNYS DRIVERS LISCENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220830000590 NY Practitioner - Nurse Practitioner 7517341209 Reassigns benefits to 2 organizations
I20230926000053 NJ Practitioner - Nurse Practitioner 7517341209 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9716723NYMDHome Health Registered Nurse
349483NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bastidas Plastic Surgery, PC CurrentSince Jan 30, 2024 Accepting new patients
Renew Wound Care of New Jersey LLC CurrentSince Sep 23, 2024 Accepting new patients
Medicine Check PC CurrentSince Jan 30, 2024 Accepting new patients
Wound Healing Associates PC CurrentSince Jan 1, 2025 Accepting new patients
Renew Medical of New York, PLLC CurrentSince Jul 25, 2024 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Nov 6, 2023 Accepting new patients

Locations

221 County Rd
#One
Cresskill, NJ 07626
Phone (201) 567-4444

290 Lafayette Ave
Hawthorne, NJ 07506
Phone (973) 423-0789

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

228 Roseberry St
Ste 5
Phillipsburg, NJ 08865
Phone (908) 213-3433

277 Route 70
Ste 231
Toms River, NJ 08755
Phone (212) 516-2300

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

691 92nd St
Brooklyn, NY 11228
Phone (718) 567-1000

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

116 E 125th St
New York, NY 10035
Phone (212) 395-9000

284 Troy Rd
Rensselaer, NY 12144
Phone (518) 286-1621

385 Seneca Ave
Ridgewood, NY 11385
Phone (201) 843-7574

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1811490733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WHEELER RD UNIT 5154",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117886007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 WHEELER RD UNIT 5154",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117886007",
            "telephone_number": "631-636-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEJULI",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "9716723",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS DRIVERS LISCENSE",
            "identifier": "634823245",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.