Active NPI
Steven A Wolman, D.M.D.
- Endodontics
- Longmeadow, MA
National Provider Identifier
1134115132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 11117
- Practice address
- 292 Pinewood Dr
Longmeadow, MA 01106-1642 - Phone
- (413) 567-6011
- NPI assigned
- Sep 25, 2005
- Last updated
- Mar 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 11117 | MA | Primary |
Addresses
Primary practice location
292 Pinewood Dr
Longmeadow, MA 01106-1642
Mailing address
292 Pinewood Dr
Longmeadow, MA 01106-1642
Phone (413) 567-6011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150515000727 | MA | Order and Referring Only - Other (Physician) | 1254651128 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11117 | MA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362355200000",
"number": "1134115132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "292 PINEWOOD DR",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061642",
"telephone_number": "413-567-6011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "292 PINEWOOD DR",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061642",
"telephone_number": "413-567-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLMAN",
"first_name": "STEVEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-25",
"last_updated": "2013-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "11117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.