Individual provider Active NPI

Logan Gabriel Hoffman, PA-C

  • Surgical Physician Assistant
  • Wexford, PA
National Provider Identifier
1073393104
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA065095 Issued in PA
Practice address
6001 Stonewood Dr
Wexford, PA 15090-7380
Phone
(724) 933-3850
Fax
(724) 933-3880
NPI assigned
Oct 5, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X MA065095 PA Primary

Addresses

Primary practice location

6001 Stonewood Dr
Wexford, PA 15090-7380

Mailing address

6001 Stonewood Dr
Wexford, PA 15090-7380
Phone (724) 933-3850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231103000364 PA Practitioner - Physician Assistant 0042667651 Reassigns benefits to 1 organization
I20250820005068 MD Practitioner - Physician Assistant 0042667651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2435 W Belvedere Ave
Baltimore, MD 21215-5224

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Aug 16, 2025 Accepting new patients
Sinai Hospital of Baltimore Inc Single Specialty CurrentSince Aug 16, 2025 Accepting new patients
Sinai Hospital of Baltimore Inc Single Specialty Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1073393104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 STONEWOOD DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150907380",
            "telephone_number": "724-933-3850",
            "fax_number": "724-933-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 STONEWOOD DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150907380",
            "telephone_number": "724-933-3850",
            "fax_number": "724-933-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "LOGAN",
        "middle_name": "GABRIEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA065095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.