Wellcare TCCM

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WELLCARE TCCM

Practice address

250 Moore St
Hackensack, NJ 07601-7506

Phone

(201) 686-8734

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Kaitlyn Gomez

Title

Owner

Phone

(201) 686-8734

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1982245932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MOORE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017506",
            "telephone_number": "201-686-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MOORE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017506",
            "telephone_number": "201-686-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE TCCM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-686-8734"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Weiss, M.D.
• Richard Barry Weiss, DMD
• Yedidyah Ephraim Weiss, MD
• Barry Joel Weissman, MD
• Stephen M Weitzman, MD
• Rosemarie Wellman, APN
• Erin Doherty Welsh, PA-C
• Perry Wengrofsky
• Catherine Anne Wenz, DNP, AGAC-NP
• Mordecai Wertheim, M.D

• Internal Medicine Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.