Individual provider Active NPI

Joseph Leon Wollman

  • Emergency Medicine Physician
  • Gardner, MA
National Provider Identifier
1134563489
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
283781 Issued in MA
Practice address
242 Green St
Gardner, MA 01440-1373
Phone
(978) 632-3420
NPI assigned
Apr 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301103329 MI
Emergency Medicine Physician 207P00000X 283781 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1373

Mailing address

242 Green St
Gardner, MA 01440-1373
Phone (978) 632-3420

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200909000562 MA Practitioner - Emergency Medicine 3476855768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of Massachusetts PCGroup PAC ID 4981069580, 44 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
283781MAMDEmergency Medicine Physician
4301103329MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athol Memorial Hospital Incorporated Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Emergency Physician Associates of Massachusetts PC Emergency Medicine CurrentSince Mar 1, 2024 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Henry Heywood Memorial Hospital Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

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.

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1134563489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401373",
            "telephone_number": "978-632-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401373",
            "telephone_number": "978-632-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLMAN",
        "first_name": "JOSEPH",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301103329",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "283781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.