Robert J. Wielenga, MD, a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G81044 Issued in CA

Legal business name

ROBERT J. WIELENGA, MD, A PROFESSIONAL CORPORATION

Practice address

10835 New St
Downey, CA 90241-3714

Phone

(562) 923-9100

Fax

(562) 923-9103

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Robert James Wielenga, M.D.NPI 1952469850

Title

Ceo

Phone

(562) 923-9100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert James Wielenga, M.D.

  • Family Medicine Physician
  • Downey, CA
  • NPI 1952469850
  Medicare reassignment NPD Authorized official
• Joan Nkechi Anukam, FNP

  • Nurse Practitioner
  • McKinney, TX
  • NPI 1013382373
  NPD
• Meldy Y Avila, NP

  • Family Nurse Practitioner
  • Murrieta, CA
  • NPI 1760623854
  NPD (past)
• Vanessa Clark, PA-C

  • Medical Physician Assistant
  • Downey, CA
  • NPI 1225588171
  NPD (past)
• Monique Denise Leelin Macasaet, NP-C

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1205205382
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1043363807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10835 NEW ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413714",
            "telephone_number": "562-923-9100",
            "fax_number": "562-923-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10835 NEW ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413714",
            "telephone_number": "562-923-9100",
            "fax_number": "562-923-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. WIELENGA, MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "WIELENGA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-923-9100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G81044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Isabel Rivera
• Daniel Rizo Jacobo
• Katherine Ro
• Young Za Ro, MD
• Andrea Roa
• Veronica Robertos, MASTERS
• Kiana Lee Roberts, OTR/L
• Michael James Roberts, D.O.
• Stacy Robertson
• Geraldine Robinson

• Family Medicine Physician in Downey, CA
• Providers in Downey, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.