NPIMap

Individual provider Active NPI

Jessica Wen, MD

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1285052142
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2020-00805 Issued in NC
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-2200
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2020-00805 NC Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

1000 Fell St Apt 603
Baltimore, MD 21231-3554
Phone (216) 375-8932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200526000663 SC Practitioner - Diagnostic Radiology 5193039725 Reassigns benefits to 1 organization
I20200526000829 NC Practitioner - Diagnostic Radiology 5193039725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

1656 Riverchase Blvd
Suite 1200
Rock Hill, SC 29732-0270
Phone (803) 327-9934

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Union Medical Services LLC Diagnostic Radiology CurrentSince Jul 15, 2020 Accepting new patients
Carolinas Imaging Services, LLC CurrentSince Jul 15, 2020 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Charlotte Radiology P a CurrentSince Jul 1, 2020 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

12335 N Community House Rd
Ste B
Charlotte, NC 28277

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2134 14th Avenue Cir NW
Ste D
Hickory, NC 28601
Phone (828) 580-1236

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

7666 Charlotte Hwy
Ste 120
Indian Land, SC 29707
Phone (803) 328-6281

1656 Riverchase Blvd
Ste 1200
Rock Hill, SC 29732
Phone (803) 327-9934

Interoperability endpoints

  • Direct secure messaging: jwen391802@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: jwen211360@direct.hopkinsmedicine.org

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1285052142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FELL ST APT 603",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313554",
            "telephone_number": "216-375-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEN",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2020-00805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.