Individual provider Active NPI

David Samuel Wenger

  • Internal Medicine Physician
  • Kirkland, WA
National Provider Identifier
1386919686
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.MD.60481954 Issued in WA
Practice address
12303 NE 130TH LN Ste 550
Kirkland, WA 98034-3041
Phone
(425) 899-6972
Fax
(425) 899-6970
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ML 60285219 WA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD.MD.60481954 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN Ste 550
Kirkland, WA 98034-3041

Mailing address

12303 NE 130TH LN Ste 550
Kirkland, WA 98034-3041
Phone (425) 899-6972

Other practice location 1

1959 NE Pacific St
Seattle, WA 98195-6421
Phone (206) 543-3605

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150829000135 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8921322967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12303 NE 130TH LN
Suite 550
Kirkland, WA 98034-3041
Phone (425) 899-6972

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.MD.60481954WAMDInternal Medicine Physician
ML 60285219WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 15, 2020 Accepting new patients
King County Public Hospital District No 2 Internal Medicine CurrentSince Apr 15, 2020 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12303 NE 130th Ln
Ste 550
Kirkland, WA 98034
Phone (425) 899-3224

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 4

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 3

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1386919686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN STE 550",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343041",
            "telephone_number": "425-899-6972",
            "fax_number": "425-899-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN STE 550",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343041",
            "telephone_number": "425-899-6972",
            "fax_number": "425-899-6970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981956421",
            "country_code": "US",
            "telephone_number": "206-543-3605",
            "fax_number": "206-744-8516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENGER",
        "first_name": "DAVID",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "ML 60285219",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD.MD.60481954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.