NPIMap

Individual provider Active NPI

Wesley E Kinzie, MD

  • Orthopaedic Surgery Physician
  • Modesto, CA
National Provider Identifier
1215039094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G048580 Issued in CA
Practice address
1401 Spanos CT #101
Modesto, CA 95355-2811
Phone
(209) 525-3140
Fax
(209) 525-3894
NPI assigned
Sep 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G048580 CA Primary

Addresses

Primary practice location

1401 Spanos CT #101
Modesto, CA 95355-2811

Mailing address

1401 Spanos CT #101
Modesto, CA 95355-2811
Phone (209) 525-3140

Other identifiers 1

IdentifierTypeStateIssuer
00G485800MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000504 CA Practitioner - Orthopedic Surgery 2365441631 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1401 Spanos CT
Suite 101
Modesto, CA 95355-2811
Phone (209) 525-3140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.96 of 100Reported as individual
Quality
3.5
Improvement activities
0
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement34
Knee replacement96
Lower limb (leg) arthroscopy (minimally invasive joint repair)33
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G048580CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Memorial Hospital Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

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

Hospital & facility affiliations 5

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215039094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT #101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552811",
            "telephone_number": "209-525-3140",
            "fax_number": "209-525-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT #101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552811",
            "telephone_number": "209-525-3140",
            "fax_number": "209-525-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZIE",
        "first_name": "WESLEY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G048580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G485800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.