RALPH WHEELER MD
NPI 1194706895
Radiology - Diagnostic Radiology in Wayne, NJ
NPI Status: Active since November 09, 2005
- Individual
- Male
- Radiology
- Diagnostic Radiology
- PECOS Enrolled
- Opted-Out Medicare
About RALPH WHEELER
This page provides the complete NPI Profile along with additional information for Ralph Wheeler, a provider established in Wayne, New Jersey with a medical specialization in Radiology, focusing in diagnostic radiology . The healthcare provider is registered in the NPI registry with number 1194706895 assigned on November 2005. The practitioner's primary taxonomy code is 2085R0202X with license number 25MA06322000 (NJ). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1194706895
- Provider Name
- RALPH WHEELER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 220 HAMBURG TPKE WAYNE, NJ 07470
- Location Phone
- (973) 904-0404
- Mailing Address
- PO BOX 9132 BROOKLINE, MA 02446
- Mailing Phone
- (603) 893-9784
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-09-2005
- Last Update Date
- 05-18-2010
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Ralph Wheeler opted out of Medicare effective on 01-01-2021 until 01-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Diagnostic Radiology
- Taxonomy Code
- 2085R0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA06322000
- License State
- NJ
- Taxonomy Description
- A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| G74569 | MEDICARE UPIN (02) | ||
| 8651400 | MEDICAID (05) | MA | |
| 049520RQT | MEDICARE ID-TYPE UNSPECIFIED (04) | MA |
Medicare Participation & PECOS Enrollment Status
Ralph Wheeler is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2021
Opt-Out End Date: 01-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 07470 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $98.09
- Minimum New Patient Price $63.84
- Maximum New Patient Price $190.92
- Average New Patient Copayment $24.52
- Minimum New Patient Copayment $15.96
- Maximum New Patient Copayment $47.73
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $79.09
- Minimum Established Patient Price $20.97
- Maximum Established Patient Price $155.92
- Average Established Patient Copayment $19.77
- Minimum Established Patient Copayment $5.24
- Maximum Established Patient Copayment $38.98
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 9 | 4 | 7 | 0 | 6 | 8 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 18 | 4 | 14 | 0 | 12 | 8 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 8 + 4 + 1 + 4 + 0 + 1 + 2 + 8 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1194706895 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1033117171 | DR. JOSEPH DUFFY M.D. Individual | Family Medicine | 220 HAMBURG TPKE SUITE 14 WAYNE, NJ 07470 (973) 942-0200 |
| 1932193521 | HARVEY COOPER MD Individual | Internal Medicine (Hematology & Oncology) | 220 HAMBURG TPKE STE G3 WAYNE, NJ 07470 (973) 942-0040 |
| 1467433813 | STEVEN FESTA MD Individual | Radiology (Diagnostic Radiology) | 220 HAMBURG TPKE WAYNE, NJ 07470 (973) 904-0404 |
| 1003888934 | DR. ABAS ANDRE REZVANI MD Individual | Urology | 220 HAMBURG TPKE 10 WAYNE, NJ 07470 (973) 790-1100 |
| 1790731271 | COMPREHENSIVE WOMENS HEALTHCARE Organization | Specialist | 220 HAMBURG TPKE 21 WAYNE, NJ 07470 (973) 790-8090 |
| 1003851288 | DR. PHILIP JOHN FILIPPIS II M.D. Individual | Internal Medicine (Infectious Disease) | 220 HAMBURG TPKE SUITE 2 WAYNE, NJ 07470 (973) 389-9975 |
| 1952331746 | DR. BERNARD HENSON MD Individual | Surgery | 220 HAMBURG TPKE SUITE 18A WAYNE, NJ 07470 (973) 904-1704 |
| 1780614537 | DR. HERBERT SIMON MAIER M.D. Individual | Dermatology | 220 HAMBURG TPKE SUITE 22 WAYNE, NJ 07470 (973) 595-6338 |
| 1992736896 | DR. HARROLD SETH LEADER M.D. Individual | Psychiatry & Neurology (Neurology) | 220 HAMBURG TPKE SUITE 16 WAYNE, NJ 07470 (973) 942-4778 |
| 1770518441 | BRUCE KEVIN BENNETT MD Individual | Obstetrics & Gynecology | 220 HAMBURG TPKE WAYNE, NJ 07470 (973) 790-8090 |
| 1891806956 | JOSEPH M. DUFFY MD PA Organization | Family Medicine | 220 HAMBURG TPKE SUITE 14 WAYNE, NJ 07470 (973) 942-0200 |
| 1376643973 | FRANK LOUIS GAZZILLO JR. MD Individual | Psychiatry & Neurology (Neurology) | 220 HAMBURG TPKE SUITE 16 WAYNE, NJ 07470 (973) 942-4778 |
| 1629165337 | DR. CHARLES SCOT REING M.D. Individual | Specialist | 220 HAMBURG TPKE SUITE 7 WAYNE, NJ 07470 (973) 790-1300 |
| 1982791596 | DR. NANCY HAE-JIN CHOO M.D. Individual | Specialist | 220 HAMBURG TPKE SUITE 7 WAYNE, NJ 07470 (973) 790-1300 |
| 1205917978 | ADOLPHUS CHUKWUELUA ONWUDINJO M.D. Individual | Obstetrics & Gynecology | 220 HAMBURG TPKE 21 WAYNE, NJ 07470 (973) 790-8090 |
| 1316082118 | NANCY R FOGEL CNM Individual | Advanced Practice Midwife | 220 HAMBURG TPKE SUITE 21 WAYNE, NJ 07470 (973) 790-8090 |
| 1437342466 | LINDSAY E BONSANTO APN-C Individual | Nurse Practitioner (Adult Health) | 220 HAMBURG TPKE SUITE 2 WAYNE, NJ 07470 (973) 389-9975 |
| 1275714511 | PHILIP J. FILIPPIS, M.D. , P.C. Organization | Internal Medicine (Infectious Disease) | 220 HAMBURG TPKE SUITE 2 WAYNE, NJ 07470 (973) 389-9975 |
| 1407095953 | ABAS REZVANI M.D., PA Organization | Specialist | 220 HAMBURG TPKE SUITE NUMBER 10 WAYNE, NJ 07470 (973) 790-1100 |
| 1699902692 | ADVANCED EYE CARE CENTER Organization | Durable Medical Equipment & Medical Supplies | 220 HAMBURG TPKE SUITE 7 WAYNE, NJ 07470 (973) 790-0179 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194706895, enumerated in the NPI registry as an "individual" on November 09, 2005
The provider is located at 220 Hamburg Tpke Wayne, Nj 07470 and the phone number is (973) 904-0404
The provider's speciality is Radiology with taxonomy code 2085R0202X with a focus in Diagnostic Radiology
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $98.09 with an average copayment of $24.52 for new patient appointments. Established patients should expect a typical charge of $79.09 and an average copayment of 19.77. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on January 01, 2021 to opt-out of the Medicare program. The provider is excluded from the Medicare program until January 01, 2027.
This NPI record was last updated on November 09, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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