Sean Daryl Wengroff, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

L4167 Issued in TX

Practice address

540 W 15TH St
Hereford, TX 79045

Phone

(806) 364-7512

Fax

(806) 349-5652

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maxie C Sprott II MD PAGroup PAC ID 6800980525, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maxie C Sprott II MD PA

  • Specialist
  • Beaumont, TX
  • NPI 1326134594
  Medicare reassignment Care Compare group NPD
• Texas Health Foundation, Inc

  • Obstetrics & Gynecology Physician
  • Beaumont, TX
  • NPI 1992473391
  Medicare reassignment NPD
• Baptist Hospitals of Southeast Texas

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1093744187
  NPD (past)
• Christus Health Southeast Texas

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1679557888
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1043273873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W 15TH ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790452820",
            "telephone_number": "806-364-7512",
            "fax_number": "806-349-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 15TH ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "79045",
            "telephone_number": "806-364-7512",
            "fax_number": "806-349-5652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6409 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "775914017",
            "country_code": "US",
            "telephone_number": "409-935-5926",
            "fax_number": "409-935-5840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENGROFF",
        "first_name": "SEAN",
        "middle_name": "DARYL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "L4167",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L4167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163758901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8K4080",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Unlimited Case Management
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP
• Walcott Isd
• Dori Lyn Wasmundt, PAC
• Whiteface Dental PLLC
• Michelle Lynn Williams, FNP
• Vanessa Yardley, CRNA
• Monica Zepeda, LVN

• Obstetrics & Gynecology Physician in Hereford, TX
• Providers in Hereford, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.