Active NPI
Daniel E Wendt, DPM
- Podiatrist
- San Diego, CA
National Provider Identifier
1205947611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3302
- Practice address
- 3555 Kenyon St
Suite 200
San Diego, CA 92110-5341 - Phone
- (619) 221-9547
- Fax
- (619) 224-7269
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E3302 | CA | Primary |
Addresses
Primary practice location
3555 Kenyon St
Suite 200
San Diego, CA 92110-5341
Mailing address
3555 Kenyon St
Suite 200
San Diego, CA 92110-5341
Phone (619) 221-9547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E33020 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E3302 | CA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372291200000",
"number": "1205947611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 KENYON ST",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105341",
"telephone_number": "619-221-9547",
"fax_number": "619-224-7269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 KENYON ST",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105341",
"telephone_number": "619-221-9547",
"fax_number": "619-224-7269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDT",
"first_name": "DANIEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2013-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E3302",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E33020",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.