Wesley Maunder Vietzke, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

013073 Issued in CT

Practice address

15 W Haycock Point Rd
Branford, CT 06405-5307

Phone

(203) 488-4688

Fax

(203) 488-9087

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medoptions Behavioral Health Assoc, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
  • NPI 1588604060
  NPD (past)
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689770372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W HAYCOCK POINT RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064055307",
            "telephone_number": "203-488-4688",
            "fax_number": "203-488-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W HAYCOCK POINT RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064055307",
            "telephone_number": "203-488-4688",
            "fax_number": "203-488-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIETZKE",
        "first_name": "WESLEY",
        "middle_name": "MAUNDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "013073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Vargas, PA
• Evadne Claudia Vascianna, FNP-C
• Tomas E Veiga, CRNFA
• Matthew David Vesely, M.D., PH.D
• Barbara Feroe Vietzke, LCSW
• Vision Center
• Amy A Vitale, MS,BA,LADC,LPC
• W & J Homecare
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP.

• All providers in Branford, CT
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.