Active NPI
Jonathon Charles Wenke, FNP
- Family Nurse Practitioner
- Bay Shore, NY
National Provider Identifier
1124681242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 344101
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 344101 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremed Primary and Urgent Care PC | Family | Current | 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.