Individual provider Active NPI

Eston K. Wenger, MD

  • Surgery Physician
  • Cleveland, TN
National Provider Identifier
1871659359
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
42393 Issued in TN
Practice address
2253 Chambliss Ave NW Ste 100
Cleveland, TN 37311-3861
Phone
(423) 472-5423
Fax
(423) 476-5523
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 42393 TN Primary

Addresses

Primary practice location

2253 Chambliss Ave NW Ste 100
Cleveland, TN 37311-3861

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5700

Other identifiers 1

IdentifierTypeStateIssuer
3000092MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070720000433 TN Practitioner - General Surgery 7810098829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Cincinnati College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Surgical Associates PLLCGroup PAC ID 1254224181, 61 clinicians

Practice addresses (Care Compare)

2175 Chambliss Ave NW
Suite D
Cleveland, TN 37311-3842
Phone (423) 472-5423

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
64.09
Promoting interoperability
98
Improvement activities
40
Cost
77.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal64
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42393TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgical Associates, PLLC Surgery CurrentSince Mar 2, 2019 Accepting new patients
Premier Surgical Associates, PLLC Surgery CurrentSince Mar 2, 2019 Accepting new patients

Locations

2175 Chambliss Ave NW
Ste D
Cleveland, TN 37311
Phone (423) 472-1140

6408 Papermill Dr
Ste 220
Knoxville, TN 37919
Phone (865) 306-5675

9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1871659359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5700",
            "fax_number": "865-584-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 100",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-472-5423",
            "fax_number": "423-476-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "ESTON",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "42393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000092",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.