Active NPI
Andrew Willis Wertz, MD
- Neonatal-Perinatal Medicine Physician
- Sacramento, CA
National Provider Identifier
1013909621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- C34429
- Practice address
- 2825 Capitol Ave FL 1
Sacramento, CA 95816-6039 - Phone
- (916) 887-0104
- Fax
- (916) 887-0112
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | C34429 | CA | Primary |
Addresses
Primary practice location
2825 Capitol Ave FL 1
Sacramento, CA 95816-6039
Mailing address
2750 Gateway Oaks Dr Ste 150
Sacramento, CA 95833-3668
Phone (916) 887-7398
Other practice location 1
1020 29th St Ste 480
Sacramento, CA 95816-5173
Phone (916) 887-0780
Other practice location 2
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 731-1537
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C344290 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120508000209 | CA | Order and Referring Only - Pediatric Medicine | 4880798743 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter North Medical Foundation | Past | Accepting new patients | |
| Perinatal & Pediatric Specialists Medical Group Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Sacramento, CA
- NPI 1114007432
-
- Ambulatory Surgical Clinic/Center
- Yuba City, CA
- NPI 1144251521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529020800000",
"number": "1013909621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2750 GATEWAY OAKS DR STE 150",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958333668",
"telephone_number": "916-887-7398",
"fax_number": "916-503-3886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 CAPITOL AVE FL 1",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958166039",
"telephone_number": "916-887-0104",
"fax_number": "916-887-0112"
}
],
"practiceLocations": [
{
"address_1": "1020 29th St Ste 480",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958165173",
"country_code": "US",
"telephone_number": "916-887-0780",
"fax_number": "916-887-0786",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Plaza Dr",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956613037",
"country_code": "US",
"telephone_number": "916-731-1537",
"fax_number": "916-731-1538",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WERTZ",
"first_name": "ANDREW",
"middle_name": "WILLIS",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2018-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "C34429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C344290",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.