Individual provider Active NPI

Michael Hanlon Wynn, DPM

  • Foot & Ankle Surgery Podiatrist
  • Kingwood, TX
National Provider Identifier
1013919471
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DP0780 Issued in TX
Practice address
23972A Highway 59 N
Kingwood, TX 77339-1535
Phone
(281) 540-1444
Fax
(281) 432-5865
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP0780 TX
Foot & Ankle Surgery Podiatrist 213ES0103X DP0780 TX Primary

Addresses

Primary practice location

23972A Highway 59 N
Kingwood, TX 77339-1535

Mailing address

23972A Highway 59 N
Kingwood, TX 77339-1535
Phone (281) 540-1444

Other identifiers 1

IdentifierTypeStateIssuer
112230102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100922000849 TX Practitioner - Podiatry 4880618586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23972A Hwy 59 N
Kingwood, TX 77339-1535
Phone (281) 540-1444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP0780TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Care Associates of Texas PA Foot & Ankle Surgery CurrentSince Aug 1, 1995 Accepting new patients

Locations

23972A Highway 59 N
Kingwood, TX 77339
Phone (281) 540-1444

23972A Highway 59 N
Ste A
Kingwood, TX 77339

23972 Highway 59 N
#A
Kingwood, TX 77339
Phone (281) 540-1444

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1013919471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23972A HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391535",
            "telephone_number": "281-540-1444",
            "fax_number": "281-446-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23972A HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391535",
            "telephone_number": "281-540-1444",
            "fax_number": "281-432-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "MICHAEL",
        "middle_name": "HANLON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "DP0780",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "DP0780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112230102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.