Organization Active NPI

Next Wave Pediatric ENT LLC

  • Pediatric Otolaryngology Physician
  • Cherry Hill, NJ
National Provider Identifier
1831911395
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
Legal business name
NEXT WAVE PEDIATRIC ENT LLC
Practice address
1940 Route 70 E Ste 1
Cherry Hill, NJ 08003-2141
Phone
(609) 696-5929
Fax
(609) 696-5619
NPI assigned
Oct 28, 2024
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Ryan D Walker, MDNPI 1457675589
Title
Owner
Phone
(609) 696-5929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X NU Primary

Addresses

Primary practice location

1940 Route 70 E Ste 1
Cherry Hill, NJ 08003-2141

Mailing address

1940 Route 70 E Ste 1
Cherry Hill, NJ 08003-2141
Phone (609) 696-5929

Other identifiers 2

IdentifierTypeStateIssuer
25MA09871200OtherNJNEW JERSEY BOARD OF MEDICAL EXAMINERS
0514390MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250103000277 NJ Part B Supplier - Clinic/Group Practice 9739616715 Receives reassigned benefits from 4 practitioners
Practice locations: Cherry Hill, NJ

National Provider Directory

National Provider Directory

Locations

1940 Route 70 E
Ste 1
Cherry Hill, NJ 08003
Phone (609) 696-5929

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1831911395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 ROUTE 70 E STE 1",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032141",
            "telephone_number": "609-696-5929",
            "fax_number": "609-696-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ROUTE 70 E STE 1",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032141",
            "telephone_number": "609-696-5929",
            "fax_number": "609-696-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXT WAVE PEDIATRIC ENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-696-5929",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY BOARD OF MEDICAL EXAMINERS",
            "identifier": "25MA09871200",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0514390",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.