Michael Scott Wenzel, M.D., F.A.A.F.P.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101057449 Issued in VA

Practice address

12255 Fair Lakes Pkwy
Kaiser Permanente Fair Oaks Medical Center
Fairfax, VA 22033-3952

Phone

(703) 934-5700

Fax

(703) 934-5835

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1699776591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 FAIR LAKES PKWY",
            "address_2": "KAISER PERMANENTE FAIR OAKS MEDICAL CENTER",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333952",
            "telephone_number": "703-934-5700",
            "fax_number": "703-934-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "M.D., F.A.A.F.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "1025416",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD039465",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101057449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "12475 Lee Jackson Memorial Hwy",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220332803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen M. Wells, LCSW
• Kelley Wells
• Jonathan Russ Wemple
• Victor Alberto Wenger, REHABILITATION PROVI
• Michelle Wenz, LCSW, CTRP-C
• Beth Anne Werfel, ED.S.
• Kristen E. Werner, M.S.W., L.C.S.W
• Ryan Jeffrey Werner, CRNA
• Ray A Wertheim, M.D
• Jessica Wertz, DO

• Family Medicine Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; 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.