Individual provider Active NPI

Bruce M Wenig, M.D.

  • Anatomic Pathology Physician
  • Tampa, FL
National Provider Identifier
1578562575
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
ME60205 Issued in FL
Practice address
12902 Usf Magnolia Drive
Moffitt Cancer Center - 2ND Floor, RM 2049
Tampa, FL 33612
Phone
(813) 745-2213
Fax
(813) 745-1708
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X ME60205 FL Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 153567 NY

Addresses

Primary practice location

12902 Usf Magnolia Drive
Moffitt Cancer Center - 2ND Floor, RM 2049
Tampa, FL 33612

Mailing address

PO Box 198441 Moffitt Cancer Center - 2ND Floor RM 2049
Atlanta, GA 30384-8441
Phone (813) 745-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161219002594 FL Practitioner - Pathology 7810918182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Oct 31, 2016 Accepting new patients
St Lukes Roosevelt Hospital Center PastSince Feb 1, 2007 Accepting new patients
Saint Lukes Roosevelt Hospital - Pathology Dept Anatomic Pathology & Clinical Pathology Past Accepting new patients
Montefiore Medical Center Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

12902 Usf Magnolia Dr
Fl 2
Tampa, FL 33612
Phone (813) 745-2213

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.

Hospital & facility affiliations 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1578562575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441 MOFFITT CANCER CENTER - 2ND FLOOR RM 2049",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DRIVE",
            "address_2": "MOFFITT CANCER CENTER - 2ND FLOOR, RM 2049",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-2213",
            "fax_number": "813-745-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENIG",
        "first_name": "BRUCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "FL",
            "license": "ME60205",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "153567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.