Individual provider Active NPI

Sven Kjellgren Wust, M.D.

  • Allergy & Immunology Physician
  • Bedford, TX
National Provider Identifier
1467590448
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
K8861 Issued in TX
Practice address
2305 Central Park Blvd
Bedford, TX 76022-6111
Phone
(940) 565-5900
Fax
(940) 565-0700
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X K8861 TX Primary

Addresses

Primary practice location

2305 Central Park Blvd
Bedford, TX 76022-6111

Mailing address

2305 Central Park Blvd
Bedford, TX 76022-6111
Phone (817) 571-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060407000117 TX Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 0143239848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Purnima Venkatesh, M.D., P.a.Group PAC ID 0345331005, 2 clinicians

Practice addresses (Care Compare)

2305 Central Park Blvd
Bedford, TX 76022-6111
Phone (817) 571-6622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K8861TXMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Purnima Venkatesh, M.D., P.a. Allergy & Immunology CurrentSince Aug 1, 2018 Accepting new patients
Faac, PA PastSince Jan 1, 1997 Accepting new patients
Kma Radiology, PA Past Accepting new patients
MD on Call PA Past Accepting new patients

Locations

2305 Central Park Blvd
Bedford, TX 76022
Phone (817) 571-6622

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1467590448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 CENTRAL PARK BLVD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226111",
            "telephone_number": "817-571-6622",
            "fax_number": "817-868-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CENTRAL PARK BLVD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226111",
            "telephone_number": "940-565-5900",
            "fax_number": "940-565-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUST",
        "first_name": "SVEN",
        "middle_name": "KJELLGREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "K8861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.