Kimberly Ann Wielgus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05812000 Issued in NJ

Practice address

27 Rockport Rd
Port Murray, NJ 07865-4125

Phone

(908) 377-9403

NPI assigned

Jun 22, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.13 of 100Reported as apm

Quality

82.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St. Luke'S Warren Physician Group, PC

  • Hematology & Oncology Physician
  • Phillipsburg, NJ
  • NPI 1467725184
  NPD

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1972234672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ROCKPORT RD",
            "city": "PORT MURRAY",
            "state": "NJ",
            "postal_code": "078654125",
            "telephone_number": "908-377-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 ROCKPORT RD",
            "city": "PORT MURRAY",
            "state": "NJ",
            "postal_code": "078654125",
            "telephone_number": "908-377-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELGUS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05812000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Charles Potter, LCSW, LCADC
• Rural America Emergency Services Inc.
• Lindsay Sheridan
• Special Homes of New Jersey, Inc.
• The Arc, Warren County Chapter
• Kathy Zinckgraf, BA

• All providers in Port Murray, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.