Individual provider Active NPI

Wendy A. Vandyke, D.O.

  • Family Medicine Physician
  • Germantown, MD
National Provider Identifier
1629120621
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0059018 Issued in MD
Practice address
20528 Boland Farm Rd
Suite 104
Germantown, MD 20876-4021
Phone
(301) 972-0400
Fax
(301) 916-1453
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0059018 MD Primary

Addresses

Primary practice location

20528 Boland Farm Rd
Suite 104
Germantown, MD 20876-4021

Mailing address

20528 Boland Farm Rd
Suite 104
Germantown, MD 20876-4021
Phone (301) 972-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231229001368 NY Practitioner - Family Practice 4587014725 Reassigns benefits to 1 organization
I20250829003006 NJ Practitioner - Family Practice 4587014725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Medicine PLLCGroup PAC ID 1456879451, 23 clinicians

Practice addresses (Care Compare)

300 W 108TH St
Apt 13a
New York, NY 10025-2788
Phone (212) 280-4740

349 3Rd St
Jersey City, NJ 07302-5634
Phone (212) 280-4740

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0059018MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Family Medicine PLLC. Family Medicine CurrentSince May 19, 2025 Accepting new patients
Practice Associates Medical Group Family Medicine PastSince Jul 21, 2025 Accepting new patients
American Chiropractic Enterprise PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

219 Driggs Ave
Brooklyn, NY 11222

322 Fairview Ave
Hudson, NY 12534
Phone (518) 828-3662

315 W 70th St
Apt 1B
New York, NY 10023
Phone (212) 787-2404

535 W 110th St
Apt 1E
New York, NY 10025
Phone (212) 222-1180

55 E 87th St
Ste 1F
New York, NY 10128
Phone (212) 427-2131

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629120621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20528 BOLAND FARM RD",
            "address_2": "SUITE 104",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764021",
            "telephone_number": "301-972-0400",
            "fax_number": "301-916-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20528 BOLAND FARM RD",
            "address_2": "SUITE 104",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764021",
            "telephone_number": "301-972-0400",
            "fax_number": "301-916-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "WENDY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0059018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.