Individual provider Active NPI

Evan Wolf, M.D.,PHD

  • Ophthalmology Physician
  • Wasilla, AK
National Provider Identifier
1205801586
Registry record updated Dec 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4915 Issued in AK
Practice address
4505 E Greenstreet Cir
Wasilla, AK 99654-8425
Phone
(907) 376-2020
Fax
(907) 357-3937
NPI assigned
Feb 21, 2006
Last updated
Dec 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2010

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 4915 AK Primary

Addresses

Primary practice location

4505 E Greenstreet Cir
Wasilla, AK 99654-8425

Mailing address

4505 E Greenstreet Cir
Wasilla, AK 99654-8425
Phone (907) 376-2020

Other identifiers 1

IdentifierTypeStateIssuer
MD22351MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20041026000272 AK Practitioner - Ophthalmology 5597726463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wolf Eye Center, Inc.Group PAC ID 7012032949, 8 clinicians

Practice addresses (Care Compare)

4505 E Green St Cir
Wasilla, AK 99654-8425
Phone (907) 376-2020

Merit-based Incentive Payment System (MIPS)

Final score
70.09 of 100Reported as group
Quality
40
Improvement activities
40
Cost
80.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery724

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4915AKMDOphthalmology Physician
2235AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wolf Eye Center, Inc. Ophthalmology CurrentSince Apr 1, 2010 Accepting new patients
Classic Eyeware Past Accepting new patients
Valley Eye Associates, PC PastSince Jan 1, 2005 Accepting new patients
Alaska Center for the Blind and Visually Impaired PastSince Apr 1, 2010 Accepting new patients

Locations

4505 E Greenstreet Cir
Wasilla, AK 99654
Phone (907) 248-7770

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291420800000",
    "number": "1205801586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E GREENSTREET CIR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548425",
            "telephone_number": "907-376-2020",
            "fax_number": "907-357-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 E GREENSTREET CIR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548425",
            "telephone_number": "907-376-2020",
            "fax_number": "907-357-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "EVAN",
        "credential": "M.D.,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AK",
            "license": "4915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD22351",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.