Kenneth Jay Wepman, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

E3594 Issued in CA

Practice address

3816 Woodruff Ave
Suite #207
Long Beach, CA 90808-2147

Phone

(562) 425-2113

Fax

(562) 425-3044

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1811920093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE",
            "address_2": "SUITE #207",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147",
            "telephone_number": "562-425-2113",
            "fax_number": "562-425-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE",
            "address_2": "SUITE #207",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147",
            "telephone_number": "562-425-2113",
            "fax_number": "562-425-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEPMAN",
        "first_name": "KENNETH",
        "middle_name": "JAY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3594",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E3594",
            "primary": true
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "E3594",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CA",
            "license": "E3594",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E3594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E35940",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "330426137",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0826880001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter W Welty, M.D.
• Christopher Wen, M.D.
• Justina Alfreda Wen
• Li Wen, M.D.
• Loan Wendt
• Bridgette Werner
• James Brady Werner
• Miles R Werner
• Edan Wernik, M.D.
• Camille Werstler

• Primary Podiatric Medicine Podiatrist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.