Individual provider Active NPI

Peter Bradley Wenn, MD

  • Interventional Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1073019337
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
4301514298 Issued in MI
Practice address
1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383
Phone
(616) 685-3450
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301514298 MI
Interventional Cardiology Physician 207RI0011X 4301514298 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383

Mailing address

PO Box 776974
Chicago, IL 60677-6974
Phone (800) 494-5797

Other practice location 1

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20250611000313 MI Practitioner - Interventional CardiologyPractitioner - Internal Medicine 0749529576 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

2373 64TH St SW
Suite 1300
Byron Center, MI 49315-7975
Phone (616) 685-1350

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Aug 19, 2022 Accepting new patients
Mercy Health Westshore Cardiology Services Internal Medicine CurrentSince Jul 15, 2025 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 15, 2025 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 15, 2025 Accepting new patients
Metropolitan Hospital Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

2373 64th St SW
Ste 1300
Byron Center, MI 49315
Phone (616) 685-1350

2373 64th St SW
Ste 1304
Byron Center, MI 49315
Phone (616) 685-3450

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

310 Lafayette Ave SE
Ste 300
Grand Rapids, MI 49503
Phone (616) 685-3450

1000 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-3450

1212 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3500

1223 Mercy Dr
Muskegon, MI 49444
Phone (231) 672-3177

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2122 Health Dr SW
Wyoming, MI 49519
Phone (616) 252-5950

270 Park Ave
Fl 1
Huntington, NY 11743
Phone (631) 351-2219

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: pwenn4479085@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1073019337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776974",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776974",
            "telephone_number": "800-494-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468383",
            "telephone_number": "616-685-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-572-0123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENN",
        "first_name": "PETER",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301514298",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301514298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.