Active NPI
Todd H Wolynn, MD
- Pediatrics Physician
- Pittsburgh, PA
National Provider Identifier
1205835592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 053987-L
- Practice address
- 810 Clairton Blvd
Pittsburgh, PA 15236-4567 - Phone
- (412) 466-5004
- Fax
- (412) 466-7137
- NPI assigned
- Jul 19, 2005
- Last updated
- Jul 18, 2015
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 053987-L | PA | Primary |
Addresses
Primary practice location
810 Clairton Blvd
Pittsburgh, PA 15236-4567
Mailing address
810 Clairton Blvd
Pittsburgh, PA 15236-4567
Phone (412) 466-5004
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015182590001 | Medicaid | PA | |
| 0015182590002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053987-L | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437177600000",
"number": "1205835592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 CLAIRTON BLVD",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152364567",
"telephone_number": "412-466-5004",
"fax_number": "412-466-7137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 CLAIRTON BLVD",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152364567",
"telephone_number": "412-466-5004",
"fax_number": "412-466-7137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLYNN",
"first_name": "TODD",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2015-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "053987-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015182590001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015182590002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.