Individual provider Active NPI

Risa Michelle Wolf, M.D.

  • Pediatric Endocrinology Physician
  • Baltimore, MD
National Provider Identifier
1033375670
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
D83736 Issued in MD
Practice address
200 N Wolfe St BLDG Rm3120
Baltimore, MD 21287-0011
Phone
(410) 955-6463
Fax
(410) 955-9773
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME124446 FL
Pediatric Endocrinology Physician 2080P0205X D83736 MD Primary
Pediatrics Physician 208000000X MD441399 PA

Addresses

Primary practice location

200 N Wolfe St BLDG Rm3120
Baltimore, MD 21287-0011

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-6423

Other practice location 1

9600 W Sample Rd
Suite 505
Coral Springs, FL 33065-4045
Phone (954) 888-3666

Other identifiers 2

IdentifierTypeStateIssuer
151NHOtherFLFL BLUE
015497400MedicaidFL

Other names 1

  • Risa Michelle Small Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027001961 MD Practitioner - Pediatric Medicine 4183893944 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME124446FLMDPediatric Endocrinology Physician
D83736MDMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Pediatric Endocrinology CurrentSince Oct 1, 2017 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2017 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

200 N Wolfe St
Rm 3120
Baltimore, MD 21287
Phone (410) 955-6463

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

200 N Wolfe St
Baltimore, MD 21287
Phone (410) 614-3917

Interoperability endpoints

  • Direct secure messaging: rwolf46016@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1033375670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-6423",
            "fax_number": "410-933-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N WOLFE ST BLDG RM3120",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870011",
            "telephone_number": "410-955-6463",
            "fax_number": "410-955-9773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9600 W Sample Rd",
            "address_2": "Suite 505",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330654045",
            "country_code": "US",
            "telephone_number": "954-888-3666",
            "fax_number": "954-753-6377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "RISA",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME124446",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MD",
            "license": "D83736",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD441399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "151NH",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015497400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RISA",
            "last_name": "SMALL",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.