Lara Beth Wahlberg, DNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F307409-1 Issued in NY

Practice address

462 1St Ave
New York, NY 10016-9196

Phone

(212) 562-5278

NPI assigned

Aug 11, 2015

Sex

Female

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 NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Weill Medical College of Cornell

  • Geriatric Medicine (Internal Medicine) Physician
  • New York, NY
  • NPI 1831100882
  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1881070092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E 78TH ST",
            "address_2": "APT 2-M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100758800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLBERG",
        "first_name": "LARA",
        "middle_name": "BETH",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F307409-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric M Wahl, M.D.
• Samuel Wahl, MD
• Tracey Domingo Wahl
• Yaakov Wahl
• Staffan Wahlander, M.D.
• Charlotte Frances Wahle, MD
• Keiko Tsutaki Wahlin, NP
• Amanda Wahlstedt
• Waverly Wahome, LMSW
• Wai Ling Dental P.C.

• Primary Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.