Individual provider Active NPI

Glenn T Wetzel, MD

  • Pediatric Cardiology Physician
  • Memphis, TN
National Provider Identifier
1023074010
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
D95664 Issued in MD
Practice address
848 Adams Ave
Memphis, TN 38103
Phone
(901) 287-7337
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 39312 TN
Pediatric Cardiology Physician 2080P0202X 39312 TN
Clinical Cardiac Electrophysiology Physician 207RC0001X D95664 MD
Pediatric Cardiology Physician 2080P0202X D95664 MD Primary

Addresses

Primary practice location

848 Adams Ave
Memphis, TN 38103

Mailing address

49 N Dunlap St Ste 345
Memphis, TN 38103-2802
Phone (901) 287-5092

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5000

Other identifiers 1

IdentifierTypeStateIssuer
3325777MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041130000797 TN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic SurgeryPractitioner - Pediatric Medicine 9830154962 Reassigns benefits to 1 organization
I20221019001159 MD Practitioner - Pediatric Medicine 9830154962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, San Diego School of Medicine, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

601 N Caroline St
Baltimore, MD 21287-0006
Phone (410) 955-5080

Hospital & facility affiliations

  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D95664MDMDPediatric Cardiology Physician
39312TNMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Oct 5, 2022 Accepting new patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatric Cardiology CurrentSince Dec 1, 2010 Accepting new patients
Johns Hopkins University Pediatric Cardiology CurrentSince Oct 5, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
The Johns Hopkins Hospital Past Accepting new patients

Locations

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

600 N Wolfe St
Baltimore, MD 21287

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

Interoperability endpoints

  • Direct secure messaging: gwetzel1030558@direct.hopkinsmedicine.org

Organizations & group practices 6

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1023074010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 N DUNLAP ST STE 345",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032802",
            "telephone_number": "901-287-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-287-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "GLENN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "39312",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "39312",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MD",
            "license": "D95664",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MD",
            "license": "D95664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3325777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.