Individual provider Active NPI

Jonathon Charles Wenke, FNP

  • Family Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1124681242
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344101 Issued in NY
Practice address
375 E Main St Ste 26
Bay Shore, NY 11706-8418
Phone
(631) 891-6200
Fax
(631) 350-7803
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344101 NY Primary

Addresses

Primary practice location

375 E Main St Ste 26
Bay Shore, NY 11706-8418

Mailing address

1 E Roe Blvd
Patchogue, NY 11772-2631
Phone (631) 475-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200507001533 NY Practitioner - Nurse Practitioner 6709217730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caremed Primary and Urgent Care PCGroup PAC ID 8224353727, 21 clinicians

Practice addresses (Care Compare)

375 E Main St
Suite 26
Bay Shore, NY 11706-8418
Phone (631) 891-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
344101NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caremed Primary and Urgent Care PC Family CurrentSince Nov 3, 2025 Accepting new patients

Locations

375 E Main St
Ste 26
Bay Shore, NY 11706
Phone (631) 665-2255

266 Middle Country Rd
Coram, NY 11727
Phone (631) 475-3900

1 E Roe Blvd
Patchogue, NY 11772
Phone (631) 475-3900

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jwenke79681@direct-chsli.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1124681242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E ROE BLVD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722631",
            "telephone_number": "631-475-3900",
            "fax_number": "631-475-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST STE 26",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-891-6200",
            "fax_number": "631-350-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENKE",
        "first_name": "JONATHON",
        "middle_name": "CHARLES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.