Individual provider Active NPI

Evan Phillip Wenker, M.D.

  • Urology Physician
  • Houston, TX
National Provider Identifier
1902283195
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
S7979 Issued in TX
Practice address
13105 Wortham Center Dr
Houston, TX 77065-5611
Phone
(713) 442-4000
NPI assigned
Apr 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X S7979 TX Primary

Addresses

Primary practice location

13105 Wortham Center Dr
Houston, TX 77065-5611

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other practice location 1

15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487
Phone (713) 442-1700

Other identifiers 2

IdentifierTypeStateIssuer
428635303MedicaidTX
428635302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210802001336 TX Practitioner - Urology 5991109720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Baylor College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S7979TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Sep 20, 2021 Accepting new patients
K S Management Services LLC Past Accepting new patients

Locations

15655 Cypress Wood Medical Dr
Ste 100
Houston, TX 77014
Phone (713) 442-1700

15655 Cypress Wood Medical Dr
Houston, TX 77014
Phone (713) 442-1700

13105 Wortham Center Dr
Houston, TX 77065
Phone (713) 442-4000

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

19926 Northwest Fwy
Jersey Village, TX 77065
Phone (346) 674-2500

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800

Interoperability endpoints

  • Direct secure messaging: ewenker38473@direct.kelsey-seybold.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1902283195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 WORTHAM CENTER DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770655611",
            "telephone_number": "713-442-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770141487",
            "country_code": "US",
            "telephone_number": "713-442-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENKER",
        "first_name": "EVAN",
        "middle_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "S7979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428635303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428635302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.