Jonathan Brett Wallach, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

273533-1 Issued in NY

Practice address

254 Easton Ave
New Brunswick, NJ 08901-1766

Phone

(732) 745-8590

NPI assigned

Sep 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

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.

• Saint Peter'S University Hospital

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1114924834
  Medicare reassignment NPD
• Saint Peter'S University Hospital

  • Clinical Psychologist
  • New Brunswick, NJ
  • NPI 1376079590
  NPD

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1851640700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8590",
            "fax_number": "732-483-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "JONATHAN",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "273533-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Howard Bradley Walker, MD
• Jasmin Camila Walker, LCSW
• John A. Walker
• Briana Walsh
• Kaley Walsh
• Andrew An Wang
• Christian Wang
• Hanbin Wang Jr., MD

• Radiation Oncology Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Radiation Oncology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.