Active NPI
Susan Wendel, MD
- Pediatrics Physician
- Woburn, MA
National Provider Identifier
1982648689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 38387
- Practice address
- 3 Baldwin Green CMN
Woburn, MA 01801-1865 - Phone
- (781) 376-1771
- Fax
- (781) 376-4242
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 38387 | MA | Primary |
Addresses
Primary practice location
3 Baldwin Green CMN
Woburn, MA 01801-1865
Mailing address
3 Baldwin Green CMN
Woburn, MA 01801-1865
Phone (781) 376-1771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3202691 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38387 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preventive Medicine Associates | Past | Accepting new patients | |
| Brighton Family Practice, Inc | Past | Accepting new patients |
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.
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-
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- Brookline, MA
- NPI 1962451591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1982648689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BALDWIN GREEN CMN",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011865",
"telephone_number": "781-376-1771",
"fax_number": "781-376-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 BALDWIN GREEN CMN",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011865",
"telephone_number": "781-376-1771",
"fax_number": "781-376-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDEL",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "38387",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3202691",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.