Individual provider Active NPI

Cody Wenzel, PA

  • Medical Physician Assistant
  • Alpena, MI
National Provider Identifier
1417378985
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006900 Issued in MI
Practice address
1501 W Chisholm St
Alpena, MI 49707-1401
Phone
(989) 356-5230
NPI assigned
Dec 30, 2013
Last updated
Dec 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601006900 MI Primary

Addresses

Primary practice location

1501 W Chisholm St
Alpena, MI 49707-1401

Mailing address

473 Brege Dr
Rogers City, MI 49779-2022
Phone (989) 255-8731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140306001159 MI Practitioner - Physician Assistant 1951531243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7000

580 W College Ave
Up Health System
Marquette, MI 49855-2736
Phone (906) 228-9440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006900MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince Jan 1, 2016 Accepting new patients
Sound Inpatient Physicians-Michigan PLLC CurrentSince Jan 1, 2016 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Mar 18, 2024 Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1417378985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 BREGE DR",
            "city": "ROGERS CITY",
            "state": "MI",
            "postal_code": "497792022",
            "telephone_number": "989-255-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "CODY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-30",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.