Jeffrey N Wentzloff, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301077685 Issued in MI

Practice address

929 Business Park Dr
Traverse City, MI 49686

Phone

(231) 947-6246

Fax

(231) 947-8864

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Michigan State University College of Human Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Traverse Ophthalmology Clinic PCGroup PAC ID 4981503521, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chippewa County War Memorial Hospital Hospital, Sault Ste Marie, MI, CCN 230239

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwentzloff@direct.gtoc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Grand Traverse Ophthalmology Clinic PC

  • Ophthalmology Physician
  • Traverse City, MI
  • NPI 1265426514
  Medicare reassignment Care Compare group NPD
• Massachusetts Eye and Ear Associates, Inc.

  • Ophthalmology Physician
  • Boston, MA
  • NPI 1932574332
  NPD (past)
• South Suburban Ear, Nose & Throat Assoc Inc

  • Otolaryngology Physician
  • South Weymouth, MA
  • NPI 1568572907
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mymichigan Medical Center Sault

  • General Acute Care Hospital
  • Sault Sainte Marie, MI
  • NPI 1295756948
  Care Compare affiliation

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1508840273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 BUSINESS PARK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868683",
            "telephone_number": "231-947-6246",
            "fax_number": "231-947-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 BUSINESS PARK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-947-6246",
            "fax_number": "231-947-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZLOFF",
        "first_name": "JEFFREY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "MI",
            "license": "4901004141",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301077685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4845630",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4845640",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Well-Spring Psychiatry, P.C.
• Monica M Wellings, PA-C
• Benjamin Michael Wells
• Atalanta Welsh
• Lindsey Jean Welsh
• Timothy Donald Wentzloff, D.D.S.
• Sharon Werner, LPC
• Janet C Wessels
• West Bay Counseling
• West Bay Foot & Ankle PLLC

• Ophthalmology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.