Individual provider Active NPI

Jeffrey C Wienke Jr., DPM CWSP

  • Foot & Ankle Surgery Podiatrist
  • Lincoln, NE
National Provider Identifier
1629207261
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
345 Issued in NE
Practice address
1150 N 83Rd St
Lincoln, NE 68505-2094
Phone
(402) 483-4485
NPI assigned
Jul 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 206 SD
Podiatrist 213E00000X 000820 IA
Foot & Ankle Surgery Podiatrist 213ES0103X 345 NE Primary

Addresses

Primary practice location

1150 N 83Rd St
Lincoln, NE 68505-2094

Mailing address

1150 N 83Rd St
Lincoln, NE 68505-2094
Phone (402) 483-4485

Other identifiers 1

IdentifierTypeStateIssuer
47-0836558OtherNETAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140331000727 TX Practitioner - Podiatry 3173779212 Reassigns benefits to 1 organization
I20140625000828 NE Practitioner - Podiatry 3173779212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

1600 S 48TH St
Lincoln, NE 68506-1299

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

5055 A St
Lincoln, NE 68510-4970

Hospital & facility affiliations

  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue461
Removal of nail tissue116
Removal or shaving of skin growth28
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
000820IAMDPodiatrist
206SDMDPodiatrist
345NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Feb 1, 2021 Accepting new patients
Wagner Indian Health Service Health Center CurrentSince Feb 26, 2014 Accepting new patients
Bryan Physician Network Podiatrist PastSince Jan 1, 2021 Accepting new patients
Northwoods Surgery Center LLC Past Accepting new patients

Locations

2300 S 16th St
Fl 7
Lincoln, NE 68502
Phone (402) 321-5398

5055 A St
Ste 400
Lincoln, NE 68510
Phone (402) 483-3890

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

111 Washington Ave NW
Wagner, SD 57380
Phone (605) 384-3621

Interoperability endpoints

  • Direct secure messaging: jwienke15008@hisp.bryanhealth.org

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 3

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": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1629207261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 83RD ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052094",
            "telephone_number": "402-483-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 83RD ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052094",
            "telephone_number": "402-483-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENKE",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM CWSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-03",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SD",
            "license": "206",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "000820",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "47-0836558",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.