NPIMap

Individual provider Active NPI

Ernest Wiggins, MD

  • Diagnostic Radiology Physician
  • Shrewsbury, NJ
National Provider Identifier
1972759025
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
55636 Issued in KY
Practice address
1131 Broad Street
Suite 110
Shrewsbury, NJ 07702-4334
Phone
(732) 578-9640
Fax
(732) 578-9650
NPI assigned
Aug 8, 2008
Last updated
Feb 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME145013 FL
Vascular & Interventional Radiology Physician 2085R0204X 25MA08449300 NJ
Diagnostic Radiology Physician 2085R0202X 55636 KY Primary

Addresses

Primary practice location

1131 Broad Street
Suite 110
Shrewsbury, NJ 07702-4334

Mailing address

300 2ND Ave
Long Branch, NJ 07740-6303
Phone (732) 578-9640

Other identifiers 1

IdentifierTypeStateIssuer
0176931MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL, KY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080903000396 NJ Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7810063591 Reassigns benefits to 3 organizations
I20210504000375 FL Practitioner - Interventional Radiology 7810063591 Reassigns benefits to 3 organizations
I20230216000517 KY Practitioner - Diagnostic Radiology 7810063591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

Freehold, NJ 07728
Phone (407) 200-2355

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

132 Pin Oak Rd
Freehold, NJ 07728-9319
Phone (407) 200-2355

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

1919 E Hwy 50 101
Adventhealth Imaging Center Clermon
Clermont, FL 34711-1975
Phone (352) 717-3738

2200 Fowler Grove Blvd
Suite 60
Winter Garden, FL 34787-5597
Phone (407) 200-0538

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145013FLMDDiagnostic Radiology Physician
55636KYMDDiagnostic Radiology Physician
25MA08449300NJMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc Current Accepting new patients
Adventhealth Primary Care Network Inc CurrentSince Feb 19, 2024 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 19, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 19, 2024 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Apr 26, 2021 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ewigginsiii57777@adventhealth.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1972759025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-578-9640",
            "fax_number": "732-578-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD STREET",
            "address_2": "SUITE 110",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024334",
            "telephone_number": "732-578-9640",
            "fax_number": "732-578-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "ERNEST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME145013",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA08449300",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "55636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0176931",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

Verify at the official NPI Registry.