Individual provider Active NPI

Thomas Richard Wenker, M.D.

  • Dermatology Physician
  • Westerville, OH
National Provider Identifier
1194926014
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301085545 Issued in MI
Practice address
430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647
Phone
(614) 898-7546
Fax
(614) 794-4294
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35093223 OH
Dermatology Physician 207N00000X 4301085545 MI Primary

Addresses

Primary practice location

430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647

Mailing address

430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647
Phone (614) 898-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090804000081 OH Practitioner - Dermatology 8527111863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Skin and Cancer IncGroup PAC ID 4688608870, 11 clinicians

Practice addresses (Care Compare)

430 Altair Pkwy
Suite 210
Westerville, OH 43082-7647
Phone (614) 898-7546

Merit-based Incentive Payment System (MIPS)

Final score
45 of 100Reported as individual
Quality
40
Improvement activities
20

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision36
Removal of skin lesions615
Skin biopsy207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301085545MIMDDermatology Physician
35093223OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Skin & Cancer Inc Dermatology CurrentSince Jul 1, 2009 Accepting new patients
Central Ohio Skin & Cancer Inc Dermatology CurrentSince Jul 1, 2009 Accepting new patients

Locations

430 Altair Pkwy
Ste 210
Westerville, OH 43082
Phone (614) 898-7546

300 Polaris Pkwy
Ste 3300
Westerville, OH 43082
Phone (614) 898-7546

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1194926014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY",
            "address_2": "STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-794-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY",
            "address_2": "STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-794-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENKER",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35093223",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301085545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.