NPIMap

Individual provider Active NPI

John M Wengryn, M.D.

  • Pulmonary Disease Physician
  • Plymouth, MA
National Provider Identifier
1215927991
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
155123 Issued in MA
Practice address
116 Court St Ste 1
Plymouth, MA 02360-8710
Phone
(508) 747-1318
Fax
(508) 747-1410
NPI assigned
Oct 25, 2005
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 155123 MA Primary

Addresses

Primary practice location

116 Court St Ste 1
Plymouth, MA 02360-8710

Mailing address

116 Court St
Plymouth, MA 02360-3808
Phone (508) 747-1318

Other identifiers 1

IdentifierTypeStateIssuer
3196607MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080508000026 MA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 7517046121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Medical College of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Primary Care Associates of Plymouth, PCGroup PAC ID 5597707604, 4 clinicians

Practice addresses (Care Compare)

116 Court St
Plymouth, MA 02360-3808
Phone (508) 747-1318

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Primary Care Associates of Plymouth, PC Pulmonary Disease CurrentSince Oct 25, 2005 Accepting new patients
Beth Israel Deaconess Hospital Plymouth, Inc. Past Accepting new patients

Locations

116 Court St
Plymouth, MA 02360
Phone (508) 746-2138

116 Court St
Ste 1
Plymouth, MA 02360
Phone (508) 747-1318

Interoperability endpoints

  • Direct secure messaging: john.wengryn.1@4342.direct.athenahealth.com
  • Direct secure messaging: jwengryn252882@direct.bilh.masshiway.net

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 8

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1215927991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 COURT ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603808",
            "telephone_number": "508-747-1318",
            "fax_number": "508-747-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 COURT ST STE 1",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608710",
            "telephone_number": "508-747-1318",
            "fax_number": "508-747-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGRYN",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "155123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3196607",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.