Individual provider Active NPI

Mitchell D Wolf, MD

  • Ophthalmology Physician
  • Madison, WI
National Provider Identifier
1144261801
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
32248-020 Issued in WI
Practice address
1025 Regent St
Madison, WI 53715-1248
Phone
(608) 282-2000
Fax
(608) 282-2172
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 32248-020 WI Primary

Addresses

Primary practice location

1025 Regent St
Madison, WI 53715-1248

Mailing address

1025 Regent St
Madison, WI 53715-1248
Phone (608) 282-2000

Other identifiers 1

IdentifierTypeStateIssuer
1144261801MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mwolf264208@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100604000786 WI Practitioner - Ophthalmology 6901936731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1025 Regent St
Madison, WI 53715-1248
Phone (608) 282-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32248-020WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jan 1, 1995 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jan 1, 1995 Accepting new patients

Locations

1341 Park Ave
Columbus, WI 53925
Phone (920) 623-2431

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1025 Regent St
Madison, WI 53715
Phone (608) 282-2000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

715 W Pleasant St
Portage, WI 53901
Phone (608) 745-5900

100 N Main St
Richland Ctr, WI 53581
Phone (608) 647-8995

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1144261801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151248",
            "telephone_number": "608-282-2000",
            "fax_number": "608-282-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151248",
            "telephone_number": "608-282-2000",
            "fax_number": "608-282-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "MITCHELL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "32248-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144261801",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwolf264208@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mwolf264208@direct-ehr-ssmhc.com",
            "address_1": "1025 Regent St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1025 Regent St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.