Active NPI
John Wentz, MD
- Diagnostic Radiology Physician
- Richland Center, WI
National Provider Identifier
1902866445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 27350
- Practice address
- 333 E 2ND St
Richland Center, WI 53581-1914 - Phone
- (608) 647-6161
- Fax
- (608) 826-2710
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 27350 | WI | Primary |
Addresses
Primary practice location
333 E 2ND St
Richland Center, WI 53581-1914
Mailing address
333 E 2ND St
Richland Center, WI 53581-1914
Phone (608) 647-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30689900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27350 | WI | MD | Diagnostic Radiology Physician |
| 000000 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Express Care, Inc | Past | Accepting new patients | |
| Kenneth H. Yuska, MD, SC | Past | Accepting new patients | |
| University of Wisconsin Medical Foundation, Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1902866445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E 2ND ST",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535811914",
"telephone_number": "608-647-6161",
"fax_number": "608-826-2710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E 2ND ST",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535811914",
"telephone_number": "608-647-6161",
"fax_number": "608-826-2710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTZ",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "27350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30689900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland Center, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.