Evette S Wenzel, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA09556200 Issued in NJ

Practice address

1825 Rte 35
Wall Township, NJ 07719-3541

Phone

(732) 280-2600

Fax

(848) 469-8933

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Evette Sue Polczynski Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/7771e67c-eed3-4c07-8b39-4ee1de7dfb76/
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754
  Medicare reassignment NPD
• Ima Urgent Care

  • Urgent Care Clinic/Center
  • Shrewsbury, NJ
  • NPI 1427432244
  NPD (past)
• Jicarilla IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
  • NPI 1124220900
  NPD (past)
• Pagosa Springs Family Medical Center

  • Specialist
  • Pagosa Springs, CO
  • NPI 1235174392
  NPD (past)
• Pagosa Springs Family Medicine Center PC

  • Specialist
  • Pagosa Springs, CO
  • NPI 1023133824
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1215967963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RTE 35",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193541",
            "telephone_number": "732-280-2600",
            "fax_number": "848-469-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "EVETTE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA09556200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09556200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68431279",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVETTE",
            "last_name": "POLCZYNSKI",
            "middle_name": "SUE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles Alfred Weber, MD
• Tricia Weckenman, MS CCC-SLP
• Jennifer Weinstock
• Frances Barbara Weldon, M.A. CCC-SLP
• Well BL Opco LLC
• Kevin Wilson, LAC
• Kathryn Elizabeth Witczak, PA-C
• Robert William Wood
• William S Wood, DMD
• Natalie S Woszczak, PYS.D

• Internal Medicine Physician in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.

Verify at the official NPI Registry.