Individual provider Active NPI

Ellen Mercedes Wenzel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Vancouver, WA
National Provider Identifier
1205152576
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO60122640 Issued in WA
Practice address
601 SE 117TH Ave
Suite 240
Vancouver, WA 98683-5297
Phone
(360) 977-7815
Fax
(888) 568-4875
NPI assigned
Apr 12, 2010
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO60122640 WA
Primary Podiatric Medicine Podiatrist 213EP1101X PO60122640 WA
Radiology Podiatrist 213ER0200X PO60122640 WA
Sports Medicine Podiatrist 213ES0000X PO60122640 WA
Foot Surgery Podiatrist 213ES0131X PO60122640 WA
Foot & Ankle Surgery Podiatrist 213ES0103X PO60122640 WA Primary

Addresses

Primary practice location

601 SE 117TH Ave
Suite 240
Vancouver, WA 98683-5297

Mailing address

601 SE 117TH Ave Ste 240
Vancouver, WA 98683-5297
Phone (360) 977-7815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100702000251 WA Practitioner - Podiatry 1052442241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Physicians and Surgeons PLLCGroup PAC ID 5698806875, 2 clinicians

Practice addresses (Care Compare)

601 SE 117TH Ave
Vancouver, WA 98683-5297
Phone (360) 977-7815

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue12
Removal of nail tissue67
Removal or shaving of skin growth24
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO60122640WAMDSports Medicine Podiatrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1205152576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-977-7815",
            "fax_number": "888-568-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE",
            "address_2": "SUITE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-977-7815",
            "fax_number": "888-568-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "ELLEN",
        "middle_name": "MERCEDES",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO60122640",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WA",
            "license": "PO60122640",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "WA",
            "license": "PO60122640",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "WA",
            "license": "PO60122640",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WA",
            "license": "PO60122640",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60122640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.