Active NPI
Steven Robert Wanzek, MD
- Pulmonary Disease Physician
- Ames, IA
National Provider Identifier
1477535771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 21275
- Practice address
- 1215 Duff Ave
Ames, IA 50010-5400 - Phone
- (515) 239-4422
- Fax
- (515) 239-4777
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 21275 | IA | Primary |
Addresses
Primary practice location
1215 Duff Ave
Ames, IA 50010-5400
Mailing address
1215 Duff Ave
Ames, IA 50010-5400
Phone (515) 239-4422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0194514 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21275 | IA | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1477535771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 DUFF AVE",
"city": "AMES",
"state": "IA",
"postal_code": "500105400",
"telephone_number": "515-239-4422",
"fax_number": "515-239-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 DUFF AVE",
"city": "AMES",
"state": "IA",
"postal_code": "500105400",
"telephone_number": "515-239-4422",
"fax_number": "515-239-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANZEK",
"first_name": "STEVEN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IA",
"license": "21275",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0194514",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ames, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.