Elliott Lyle Wenger, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E1759 Issued in CA

Practice address

2929 Summit St
101
Oakland, CA 94609-3423

Phone

(510) 832-3137

Fax

(510) 338-0760

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1346285780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 OAKWOOD DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111350",
            "telephone_number": "510-832-3137",
            "fax_number": "510-338-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 SUMMIT ST",
            "address_2": "101",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093423",
            "telephone_number": "510-832-3137",
            "fax_number": "510-338-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "ELLIOTT",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E17591",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E17590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Wen, RN
• Jimmy Wen, MD
• Wendell a Williams DDS
• David A. Wender, DO
• Christiana Y. Weng, MD
• Susan Wengrofsky
• Sylvia Wenninger, MFT
• Paul J. Wensley, LCSW
• Meaghan Faith Wenzel
• Susan Elizabeth Werner, LCSW

• Podiatrist in Oakland, CA
• Providers in Oakland, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.