Individual provider Active NPI

Susan Wenzinger, ANPC

  • Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1043294374
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F3011161 Issued in NY
Practice address
4513 Old Vestal Rd
Vestal, NY 13850-3571
Phone
(607) 729-7001
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F3011161 NY Primary

Addresses

Primary practice location

4513 Old Vestal Rd
Vestal, NY 13850-3571

Mailing address

4513 Old Vestal Rd
Vestal, NY 13850-3571
Phone (607) 729-7001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000719 NY Practitioner - Nurse Practitioner 8325014699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3011161NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jun 5, 2017 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Nurse Practitioner CurrentSince Jun 5, 2017 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Sufen Gong Acupuncture Clinic Past Accepting new patients
Jill Van Pelt LCSW PLLC Past Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

161 Riverside Dr
Ste 302
Binghamton, NY 13905
Phone (607) 798-1842

20-24 S Washington St
Binghamton, NY 13903
Phone (607) 251-2300

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1043294374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 OLD VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503571",
            "telephone_number": "607-729-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 OLD VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503571",
            "telephone_number": "607-729-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZINGER",
        "first_name": "SUSAN",
        "credential": "ANPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F3011161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.