Joseph M. Wentzell, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

60351927 Issued in WA

Practice address

1934 Emerald Way
Lynden, WA 98264-9734

Phone

(360) 320-8579

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1053478396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 EMERALD WAY",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982649734",
            "telephone_number": "360-320-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 EMERALD WAY",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982649734",
            "telephone_number": "360-320-8579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15906 Mill Creek Blvd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980121797",
            "country_code": "US",
            "telephone_number": "425-385-2009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENTZELL",
        "first_name": "JOSEPH",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WY",
            "license": "4270A",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "59833",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "VA",
            "license": "0101268874",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MT",
            "license": "6255",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "60351927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "000096270",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCD PIN",
            "identifier": "0011305",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCD PIN",
            "identifier": "100431000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Washington CVS Pharmacy LLC
• Stephanie Wear, LMP
• Christina Catherine Weeks
• Andrew Weir
• Katie Welle, OTR
• Whatcom County FPD #3
• Whatcom Womens Health, LLC
• Cynthia Wilkinson
• Melinda Williamson
• Sandy Annette Wisecarver

• MOHS-Micrographic Surgery Physician in Lynden, WA
• Providers in Lynden, WA by specialty
• MOHS-Micrographic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.