Look up the most recent NPI and PECOS records

Justin Wigley

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3400 Spruce St, Philadelphia, PA 19104-4238

PECOS Enrollment

Based on the most recent information from CMS, provider Justin Wigley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1326730912
Provider Type
Individual
Full Name
Wigley, Justin
Gender
Male

Sole Proprietor
Yes
Enumeration Date
5/23/2023
Last Updated
8/2/2023

Contact Information

Practice Location

3400 Spruce St, Philadelphia, PA 19104-4238

(215) 662-4000

Unlisted Fax

Mailing Location

45 Estaugh Ave, Haddonfield, NJ 08033-2505

(609) 304-5246

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License MA064683 Pennsylvania
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Justin Wigley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Gaughan, Kaila

Patel, Shruti G

Lee, Catherine P

Muir, Sara Marie

Profit, Tasha D

Tupper, Zachary Craig

Hipp, Robert

Ou, Jennifer M.

Brusstar, Marissa Jean

Mckenna, Maria