Jessica A Wentzell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2958 Issued in MN

Practice address

101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201

Phone

(320) 231-5000

Fax

(320) 231-5067

NPI assigned

Jul 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica A Bowers Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwentzell436992@direct.centracare.com

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.

• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264
  Medicare reassignment Care Compare group NPD
• Centracare Clinic Southwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1912664889

  Optometrist

  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447280847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZELL",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOWERS",
            "middle_name": "A",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Beth Weatherby, PSYD
• Jennifer Marie Webb
• Kelly Weber, OTR/L
• Daniele J Welvaert, NP-C
• Marny Marie Wenberg, PCA
• Ann Wenzel, PHARMD
• Jim Werner I
• Laurel Wessman, MD
• West Central Interpreting Services, LLC.
• West Central Radiological Associates, LTD

• Optometrist in Willmar, MN
• Providers in Willmar, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.