Individual provider Active NPI

Wendy Tatiana Botero Torres, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1790294536
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006582 Issued in MD
Practice address
22 South Green Street
Division of Cardiac Surgery
Baltimore, MD 21201
Phone
(973) 975-7749
NPI assigned
Sep 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0006582 MD Primary

Addresses

Primary practice location

22 South Green Street
Division of Cardiac Surgery
Baltimore, MD 21201

Mailing address

506 S Ellwood Ave
Baltimore, MD 21224-3919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20171228001544 MD Practitioner - Physician Assistant 1254699051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2000

3304 Guilford Ave
Baltimore, MD 21218-2829
Phone (410) 554-6740

Hospital & facility affiliations

  • Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0006582MDMDPhysician Assistant

Organizations & group practices 2

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 1

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1790294536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S ELLWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SOUTH GREEN STREET",
            "address_2": "DIVISION OF CARDIAC SURGERY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "973-975-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO TORRES",
        "first_name": "WENDY",
        "middle_name": "TATIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2021-10-21",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.