CHARLES K WANICH MD NPI 1376642355

NPI Information

  • NPI: 1376642355
  • Provider Name: CHARLES K WANICH, MD
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 245 S COURTENAY PARKWAY
    BLDG B
    MERRITT ISLAND, FL
    ZIP 32952
  • Phone: (321) 453-5326

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NPI Details

Charles K Wanich, MD is a nephrology internal medicine in Merritt Island, FL with 54 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Charles K Wanich, MD NPI is 1376642355. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

245 S COURTENAY PARKWAY
BLDG B
MERRITT ISLAND, FL
ZIP 32952
Phone: (321) 453-5326
Fax: (321) 452-8507

The NPI 1376642355 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services, 4 or more physician visits per month (20 years or older) (HCPCS:90960)
  • Dialysis services, 2-3 physician visits per month (20 years or older) (HCPCS:90961)

The enumeration date for this NPI number is 9/22/2006 and was last updated on 10/26/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyME36933FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1039647800MEDICAIDFLORIDA
2110202974OTHERRR MEDICARE
3D54715MEDICARE UPIN
441172MEDICARE ID-TYPE UNSPECIFIED
52168973OTHERAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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