Individual provider Active NPI

Dylan S Wentzel

  • Student in an Organized Health Care Education/Training Program
  • Kansas City, KS
National Provider Identifier
1255199758
Registry record updated Jun 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone
(785) 577-3418
NPI assigned
Mar 8, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 94-12233 KS
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Mailing address

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250625002472 KS Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 8022520956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
94-12233KSMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1255199758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "785-577-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZEL",
        "first_name": "DYLAN",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-08",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KS",
            "license": "94-12233",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.