Active NPI
Michael W. Wentworth
- Family Medicine Physician
- Patuxent River, MD
National Provider Identifier
1376521963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101059065
- Practice address
- 47149 Buse Rd
BLDG 1370
Patuxent River, MD 20670-1540 - Phone
- (301) 342-9503
- Fax
- (301) 342-4718
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101059065 | VA | Primary |
Addresses
Primary practice location
47149 Buse Rd
BLDG 1370
Patuxent River, MD 20670-1540
Mailing address
47149 Buse Rd
BLDG 1370
Patuxent River, MD 20670-1540
Phone (301) 342-9503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130509000095 | WA | Order and Referring Only - Family Practice | 7618114703 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1376521963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47149 BUSE RD",
"address_2": "BLDG 1370",
"city": "PATUXENT RIVER",
"state": "MD",
"postal_code": "206701540",
"telephone_number": "301-342-9503",
"fax_number": "301-342-4718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47149 BUSE RD",
"address_2": "BLDG 1370",
"city": "PATUXENT RIVER",
"state": "MD",
"postal_code": "206701540",
"telephone_number": "301-342-9503",
"fax_number": "301-342-4718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTWORTH",
"first_name": "MICHAEL",
"middle_name": "W.",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101059065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patuxent River, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.