NPIMap

Individual provider Active NPI

Joanna Wolf Etra, M.D.

  • Trauma Surgery Physician
  • Boston, MA
National Provider Identifier
1003233560
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
DR.0071269 Issued in CO
Practice address
110 Francis St Ste 9B
Boston, MA 02215-5501
Phone
(617) 632-9513
NPI assigned
Mar 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 287050 MA
Trauma Surgery Physician 2086S0127X DR.0071269 CO Primary

Addresses

Primary practice location

110 Francis St Ste 9B
Boston, MA 02215-5501

Mailing address

110 Francis St Ste 9B
Boston, MA 02215-5501
Phone (617) 632-9513

Other practice location 1

The Johns Hopkins Hospital
600 N. Wolfe Street - Tower 110
Baltimore, MD 21287-2109
Phone (410) 955-5020

Other practice location 2

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210720002250 MA Practitioner - General Surgery 0446478838 Reassigns benefits to 1 organization
I20230801002048 CO Practitioner - General Surgery 0446478838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Aug 15, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Surgery CurrentSince Aug 1, 2021 Accepting new patients
University Physicians Incorporated Surgery Current Accepting new patients
University Physicians, Incorporated Orthopaedic Trauma CurrentSince Aug 15, 2023 Accepting new patients
University of Colorado Hospital Authority Past Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

110 Francis St
Ste 9B
Boston, MA 02215
Phone (617) 632-9236

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015

Organizations & group practices 6

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1395532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1003233560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 9B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 9B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-9513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "The Johns Hopkins Hospital",
            "address_2": "600 N. Wolfe Street - Tower 110",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212872109",
            "country_code": "US",
            "telephone_number": "410-955-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETRA",
        "first_name": "JOANNA",
        "middle_name": "WOLF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-23",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "287050",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CO",
            "license": "DR.0071269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.