Raetta Lynn Wentz, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

00552 Issued in WV

Practice address

1370 Johnson Ave
Bridgeport, WV 26330-1492

Phone

(304) 842-7186

Fax

(304) 842-2533

NPI assigned

May 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• United Physicians Care Inc

  • Family Medicine Physician
  • Shinnston, WV
  • NPI 1184849200
  Medicare reassignment Care Compare group NPD
• United Physicians Care Inc

  dba Pinewood Medical Center

  • Family Medicine Physician
  • Grafton, WV
  • NPI 1891863874
  NPD
• Salem Family Medicine Inc

  • Family Medicine Physician
  • Salem, WV
  • NPI 1215975438
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1740508779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 JOHNSON AVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301492",
            "telephone_number": "304-842-7186",
            "fax_number": "305-842-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 JOHNSON AVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301492",
            "telephone_number": "304-842-7186",
            "fax_number": "304-842-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "RAETTA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "00552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwentz41356@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2373 W Main St Ste 102",
            "city": "Salem",
            "state": "WV",
            "country_code": "US",
            "postal_code": "264267515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwentz41356@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2373 W Main St",
            "city": "Salem",
            "state": "WV",
            "country_code": "US",
            "postal_code": "264267515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David L Waxman, MD
• Christopher Waybright, APRN
• Rachel F. Weber, PT
• Gerald Wedemeyer, M.D.
• Amanda Wells
• Julie Marie Werner, MSW, LSW, QRP
• Danielle Wesoloski, OTR/L
• West Virginia CVS Pharmacy LLC (Target Pharmacy)
• West Virginia University Medical Corporation (WVU Obstetrics & Gynecology-Bridgeport)
• Brittanie West, DO

• Medical Physician Assistant in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.