Individual provider Active NPI

Allen Wendt, M.D.

  • Pediatrics Physician
  • Boynton Beach, FL
National Provider Identifier
1194793976
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME117593 Issued in FL
Practice address
10301 Hagen Ranch Rd
BLDG a, Suite 760
Boynton Beach, FL 33437-3724
Phone
(561) 733-4400
Fax
(561) 733-5004
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-108401 IL
Pediatrics Physician 208000000X C53816 CA
Pediatrics Physician 208000000X ME117593 FL Primary

Addresses

Primary practice location

10301 Hagen Ranch Rd
BLDG a, Suite 760
Boynton Beach, FL 33437-3724

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (561) 733-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100608000595 CA Practitioner - Pediatric Medicine 3072665009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C53816CAMDPediatrics Physician
ME117593FLMDPediatrics Physician
036-108401ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group Pediatrics CurrentSince Feb 1, 2017 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson Pediatrics Past Accepting new patients

Locations

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Interoperability endpoints

  • Direct secure messaging: allen.wendt.p1@direct.altura.nextgenshare.com

Organizations & group practices 3

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1194793976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "561-733-4400",
            "fax_number": "561-733-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD",
            "address_2": "BLDG A, SUITE 760",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373724",
            "telephone_number": "561-733-4400",
            "fax_number": "561-733-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-108401",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C53816",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME117593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.