NPIMap

Individual provider Active NPI

Martin T Wenthe, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1063453827
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A78460 Issued in CA
Practice address
4770 W Herndon Ave
Fresno, CA 93722-8402
Phone
(559) 271-6365
Fax
(559) 271-6326
NPI assigned
Jun 10, 2006
Last updated
Jun 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A78460 CA Primary

Addresses

Primary practice location

4770 W Herndon Ave
Fresno, CA 93722-8402

Mailing address

4770 W Herndon Ave
Fresno, CA 93722-8402
Phone (559) 271-6365

Other identifiers 2

IdentifierTypeStateIssuer
00A784600MedicaidCA
080184350OtherMEDICARE RR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081208000654 CA Practitioner - Family PracticePractitioner - General Practice 1759442866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7355 N Palm Ave
Suite 100
Fresno, CA 93711-5770
Phone (559) 271-6300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78460CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physicians Medical Group Current Accepting new patients
Community Foundation Medical Group CurrentSince Oct 1, 2013 Accepting new patients
Community Foundation Medical Group CurrentSince Oct 1, 2013 Accepting new patients

Locations

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

4770 W Herndon Ave
Fresno, CA 93722
Phone (559) 271-6300

7355 N Palm Ave
Ste 100
Fresno, CA 93711
Phone (559) 271-6300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1063453827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228402",
            "telephone_number": "559-271-6365",
            "fax_number": "559-271-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228402",
            "telephone_number": "559-271-6365",
            "fax_number": "559-271-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTHE",
        "first_name": "MARTIN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A78460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A784600",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "080184350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.