Active NPI
Jeanne M Wenzke, LISW
- Social Worker
- Santa Fe, NM
National Provider Identifier
1093033599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I-07313
- Practice address
- 1450 S Saint Francis Dr
Santa Fe, NM 87505-4038 - Phone
- (505) 944-5560
- NPI assigned
- May 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I-07313 | NM | Primary |
Addresses
Primary practice location
1450 S Saint Francis Dr
Santa Fe, NM 87505-4038
Mailing address
1004 Camino de Chelly
Santa Fe, NM 87505-6263
Phone (505) 944-5560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42121345 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-07313 | NM | MD | Social Worker |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- San Jose, CA
- NPI 1154994846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1093033599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 CAMINO DE CHELLY",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875056263",
"telephone_number": "505-944-5560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 S SAINT FRANCIS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054038",
"telephone_number": "505-944-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZKE",
"first_name": "JEANNE",
"middle_name": "M",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "I-07313",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42121345",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.