Wallace Edward Wengler, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

ME33979 Issued in FL

Practice address

509 SE Riverside Dr Ste 200
Stuart, FL 34994-2579

Phone

(772) 219-4026

Fax

(772) 219-0973

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Interoperability endpoints

• Direct secure messaging: wwengler2500893@direct.ccf.org

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.

• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• Treasure Coast Surgical Group

  • Specialist
  • Stuart, FL
  • NPI 1053366674
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1073511408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-5665",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SE RIVERSIDE DR STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942579",
            "telephone_number": "772-219-4026",
            "fax_number": "772-219-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGLER",
        "first_name": "WALLACE",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0033979",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME33979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065625900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wwengler4609@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "509 SE Riverside Dr Ste 200",
            "city": "Stuart",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349942579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wellness Works Medical Group LLC
• Wellspring Medical Solution LLC
• Wellspring Wellness and Mental Health Services, LLC
• Caroline Welsh
• Craig Adam Wengler, M.D.
• Shari Wescott
• West Palm Beach Vamc
• Jasmine West
• Samiah La'Shay West, RBT
• Oscar Westerheidy

• Surgical Oncology Physician in Stuart, FL
• Providers in Stuart, FL by specialty
• Surgical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.