NPIMap

Individual provider Active NPI

Wolfgang Christoph Kienzle, DPM

  • Podiatrist
  • Oklahoma City, OK
National Provider Identifier
1407420862
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
398 Issued in OK
Practice address
2825 Parklawn Dr
Oklahoma City, OK 73110-4201
Phone
(405) 610-4411
NPI assigned
May 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 398 OK
Podiatrist 213E00000X 398 OK Primary

Addresses

Primary practice location

2825 Parklawn Dr
Oklahoma City, OK 73110-4201

Mailing address

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

Other practice location 1

3315 Kethley Rd
Shawnee, OK 74804-9638
Phone (405) 272-7055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000193 OK Practitioner - Podiatry 2567907124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 273-2270

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue108
Removal of skin lesions1-10
Removal of nail tissue268
Removal or shaving of skin growth76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
398OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince May 4, 2024 Accepting new patients
Saints Medical Group, LLC CurrentSince May 4, 2024 Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
SSM Health Care of Oklahoma, Inc Past Accepting new patients

Locations

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

3400 S Douglas Blvd
Ste 207
Oklahoma City, OK 73150

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

Interoperability endpoints

  • Direct secure messaging: wkienzle514928@direct-ehr-ssmhc.com

Organizations & group practices 5

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 5

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1407420862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 PARKLAWN DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731104201",
            "telephone_number": "405-610-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3315 Kethley Rd",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748049638",
            "country_code": "US",
            "telephone_number": "405-272-7055",
            "fax_number": "405-272-7059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIENZLE",
        "first_name": "WOLFGANG",
        "middle_name": "CHRISTOPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "398",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.