Individual provider Active NPI

Wolfert Fayette, NP/PA

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1134788656
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024705 Issued in FL
Practice address
1300 Madison Chase Apt 5
West Palm Beach, FL 33411-6211
Phone
(929) 405-8856
NPI assigned
Jun 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11024705 FL Primary

Addresses

Primary practice location

1300 Madison Chase Apt 5
West Palm Beach, FL 33411-6211

Mailing address

13110 Guy R Brewer Blvd Apt 3H
Jamaica, NY 11434-2956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230808000137 FL Practitioner - Nurse Practitioner 9830550813
I20240709000329 NJ Practitioner - Nurse Practitioner 9830550813 Reassigns benefits to 1 organization
I20240710000785 NY Practitioner - Nurse Practitioner 9830550813 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Apr 26, 2024 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1559952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1134788656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 GUY R BREWER BLVD APT 3H",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MADISON CHASE APT 5",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116211",
            "telephone_number": "929-405-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYETTE",
        "first_name": "WOLFERT",
        "credential": "NP/PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-08",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.