Individual provider Active NPI

Dolan Paul Wenner, D.O.

  • Internal Medicine Physician
  • Erie, PA
National Provider Identifier
1801052634
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS014403 Issued in PA
Practice address
135 E 38TH St
Erie, PA 16504-1559
Phone
(814) 868-8661
NPI assigned
Jul 31, 2008
Last updated
Jan 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS014403 PA Primary

Addresses

Primary practice location

135 E 38TH St
Erie, PA 16504-1559

Mailing address

135 E 38TH St
Erie, PA 16504-1559
Phone (814) 868-8661

Other identifiers 1

IdentifierTypeStateIssuer
1023794660003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101001591 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1759420144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1801052634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041559",
            "telephone_number": "814-868-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041559",
            "telephone_number": "814-868-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNER",
        "first_name": "DOLAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS014403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023794660003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.