Individual provider Active NPI

Michael I Wiener, D.O.

  • Family Medicine Physician
  • Ridgewood, NJ
National Provider Identifier
1922091370
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB03506400 Issued in NJ
Practice address
1124 E Ridgewood Ave Ste 201
Ridgewood, NJ 07450-3943
Phone
(201) 881-7282
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AW8163812 NJ
Family Medicine Physician 207Q00000X 25MB03506400 NJ Primary

Addresses

Primary practice location

1124 E Ridgewood Ave Ste 201
Ridgewood, NJ 07450-3943

Mailing address

514 Lydia LN
Wyckoff, NJ 07481-1711
Phone (201) 891-7793

Other practice location 1

299 Market St
Saddle Brook, NJ 07663-5316
Phone (201) 368-1717

Other identifiers 1

IdentifierTypeStateIssuer
1569309MedicaidNJ

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
I20100827000245 NJ Practitioner - Family Practice 4183799943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

1124 E Ridgewood Ave
Ridgewood, NJ 07450-3941
Phone (201) 493-2310

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Clifton, NJ, CCN 317017
  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • Amedisys Home Health Home health agency, Hackensack, NJ, CCN 317047
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Feb 3, 2025 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

1124 E Ridgewood Ave
Ridgewood, NJ 07450
Phone (201) 493-2310

1124 E Ridgewood Ave
Ste 201
Ridgewood, NJ 07450
Phone (201) 447-1188

299 Market St
Ste 110
Saddle Brook, NJ 07663
Phone (201) 291-0202

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1922091370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 LYDIA LN",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811711",
            "telephone_number": "201-891-7793",
            "fax_number": "201-368-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E RIDGEWOOD AVE STE 201",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503943",
            "telephone_number": "201-881-7282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "299 Market St",
            "address_purpose": "LOCATION",
            "city": "Saddle Brook",
            "state": "NJ",
            "postal_code": "076635316",
            "country_code": "US",
            "telephone_number": "201-368-1717",
            "fax_number": "201-368-9618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIENER",
        "first_name": "MICHAEL",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "AW8163812",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB03506400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1569309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.