Individual provider Active NPI

Dominique Wolff

  • Certified Registered Nurse Anesthetist
  • Brooklyn, NY
National Provider Identifier
1033676283
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
668090 Issued in NY
Practice address
404 8TH Ave Apt 4D
Brooklyn, NY 11215-8009
Phone
(917) 881-5167
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 668090 NY
Certified Registered Nurse Anesthetist 367500000X 668090 NY Primary

Addresses

Primary practice location

404 8TH Ave Apt 4D
Brooklyn, NY 11215-8009

Mailing address

404 8TH Ave Apt 4D
Brooklyn, NY 11215-8009
Phone (917) 881-5167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191114002716 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325470230 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Apr 30, 2024 Accepting new patients
New York University CurrentSince Oct 28, 2019 Accepting new patients
New York University CurrentSince Oct 28, 2019 Accepting new patients
New York University Current Accepting new patients
Optum Medical Care, P.C. CurrentSince Apr 30, 2024 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Jan 20, 2023 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1033676283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 8TH AVE APT 4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158009",
            "telephone_number": "917-881-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 8TH AVE APT 4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158009",
            "telephone_number": "917-881-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "DOMINIQUE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "668090",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "668090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.