Individual provider Active NPI

Wendy Vandyke, GNP-BC

  • Gerontology Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1275804197
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
667620 Issued in TX
Practice address
2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650
Phone
(210) 599-6000
Fax
(210) 657-5586
NPI assigned
Jan 24, 2012
Last updated
Feb 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 667620 TX Primary

Addresses

Primary practice location

2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650

Mailing address

2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650
Phone (210) 599-6000

Other identifiers 1

IdentifierTypeStateIssuer
AP119635OtherTXLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180424000548 TX Practitioner - Nurse Practitioner 9032472154 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
667620TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Health Aftx PC CurrentSince Jan 24, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 9, 2020 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Applebaum Physiatry PLLC Gerontology CurrentSince Jan 21, 2026 Accepting new patients
Wendys Seniorcare Consulting, LLC Gerontology Current Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 9, 2020 Accepting new patients

Locations

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

11106 Christus Hls
San Antonio, TX 78251
Phone (210) 240-8241

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

1003 Columbia St
Stamford, TX 79553
Phone (325) 773-3671

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1275804197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "WENDY",
        "name_prefix": "Mrs.",
        "credential": "GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "667620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP119635",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.