Organization Active NPI

James R Wendt M D a Professional Corp

  • Plastic Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1215196100
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
JAMES R WENDT M D A PROFESSIONAL CORP
Practice address
351 Hospital Rd
Suite 601
Newport Beach, CA 92663-3509
Phone
(949) 650-3638
Fax
(949) 650-3606
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Mrs. Geri Nmi Brady
Title
Financial Representative
Phone
(940) 497-0286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

351 Hospital Rd
Suite 601
Newport Beach, CA 92663-3509

Mailing address

351 Hospital Rd
Suite 601
Newport Beach, CA 92663-3509
Phone (949) 650-3638

Other names 1

  • JAMES R WENDT M D A PROFESSIONAL CORP Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090324000547 CA Part B Supplier - Clinic/Group Practice 5496812158 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

351 Hospital Rd
Ste 601
Newport Beach, CA 92663
Phone (949) 548-2264

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1215196100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HOSPITAL RD",
            "address_2": "SUITE 601",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633509",
            "telephone_number": "949-650-3638",
            "fax_number": "949-650-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 HOSPITAL RD",
            "address_2": "SUITE 601",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633509",
            "telephone_number": "949-650-3638",
            "fax_number": "949-650-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R WENDT M D A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "GERI",
        "authorized_official_middle_name": "NMI",
        "authorized_official_title_or_position": "FINANCIAL REPRESENTATIVE",
        "authorized_official_telephone_number": "940-497-0286",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAMES R WENDT M D A PROFESSIONAL CORP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.