DALIA JEANETTE WENCKUS (MD) – Maternal & Fetal Medicine Physician, NPI 1992915623
Maternal & Fetal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
897 OBSTETRICS/GYNECOLOGY in TN
Provider Addresses for DALIA JEANETTE WENCKUS (MD)
501 19TH ST STE 401
KNOXVILLE, TN 379161831
Phone: (865) 331-2020
Type: Location
Wright-Patterson Medical Center, 4881, Sugar Maple Drive, Buckeye Trailer Court, Greene County, Ohio, 45433, United States
DEPT OF OBSTETRICS AND GYNECOLOGY
WRIGHT PATTERSON AFB, OH 454335529
Phone: (937) 257-1941
Type: Mailing
3551 Roger Brooke Dr
Fort Sam Houston, TX 782344504
Phone: (210) 539-9582
Type: Location
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 782344504
Phone: (210) 539-9582
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-04-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220511001701 | I | Obstetrics/Gynecology | MT | TBD |
| I20240625001283 | I | Obstetrics/Gynecology | IN | TBD |
| I20250416001817 | I | Obstetrics/Gynecology | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37916)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| Nurse Practitioner | TN | |
| Certified Nurse Midwife (Cnm) | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| Nurse Practitioner | TN |
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