NPIMap

Individual provider Active NPI

William W Woodruff, MD

  • Neuroradiology Physician
  • Bethlehem, PA
National Provider Identifier
1063489367
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
MD043441E Issued in PA
Practice address
95 Highland Ave
Suite 130
Bethlehem, PA 18017-9424
Phone
(610) 868-1100
Fax
(610) 868-1111
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 202045 NY
Neuroradiology Physician 2085N0700X MD043441E PA Primary

Addresses

Primary practice location

95 Highland Ave
Suite 130
Bethlehem, PA 18017-9424

Mailing address

95 Highland Ave
Suite 130
Bethlehem, PA 18017-9424
Phone (610) 868-1100

Other identifiers 2

IdentifierTypeStateIssuer
01632719MedicaidNY
001179038MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physician Associates, Inc. Neuroradiology PastSince Jul 1, 2006 Accepting new patients
Park Avenue Associates in Radiology PC Diagnostic Radiology PastSince Mar 16, 2020 Accepting new patients
Progressive Physician Assoc, Inc. Neuroradiology Past Accepting new patients

Organizations & group practices 3

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": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1063489367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HIGHLAND AVE",
            "address_2": "SUITE 130",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179424",
            "telephone_number": "610-868-1100",
            "fax_number": "610-868-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HIGHLAND AVE",
            "address_2": "SUITE 130",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179424",
            "telephone_number": "610-868-1100",
            "fax_number": "610-868-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "202045",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD043441E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01632719",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001179038",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.