Organization Active NPI

Wensley M Keith MD, PC

  • General Practice Physician
  • Newport Beach, CA
National Provider Identifier
1790530004
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WENSLEY M KEITH MD, PC
Practice address
1601 Dove St Ste 170
Newport Beach, CA 92660-1421
Phone
(949) 467-9081
Fax
(209) 203-1036
NPI assigned
Apr 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Michael Keith Wensley, MDNPI 1841336740
Title
Ceo
Phone
(949) 467-9081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1601 Dove St Ste 170
Newport Beach, CA 92660-1421

Mailing address

1601 Dove St Ste 170
Newport Beach, CA 92660-1421
Phone (949) 705-8226

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1790530004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-705-8226",
            "fax_number": "209-203-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-467-9081",
            "fax_number": "209-203-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENSLEY M KEITH MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2025-03-28",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "WENSLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-467-9081",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.