Active NPI
Marie C Wolfgang, M.D.
- Internal Medicine Physician
- Seaford, DE
National Provider Identifier
1205836079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C10003884
- Practice address
- 1 Cedar Ave
Seaford, DE 19973-3300 - Phone
- (302) 629-2366
- Fax
- (302) 629-6570
- NPI assigned
- Jul 22, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C10003884 | DE | Primary |
Addresses
Primary practice location
1 Cedar Ave
Seaford, DE 19973-3300
Mailing address
1 Cedar Ave
Seaford, DE 19973-3300
Phone (302) 629-2366
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000405701 | Medicaid | DE | |
| 110160594 | Other | RR MEDICARE | |
| 4364105 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240807001740 | DE | Order and Referring Only - Internal Medicine | 0143413781 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1205836079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CEDAR AVE",
"city": "SEAFORD",
"state": "DE",
"postal_code": "199733300",
"telephone_number": "302-629-2366",
"fax_number": "302-629-6570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CEDAR AVE",
"city": "SEAFORD",
"state": "DE",
"postal_code": "199733300",
"telephone_number": "302-629-2366",
"fax_number": "302-629-6570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFGANG",
"first_name": "MARIE",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-22",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DE",
"license": "C10003884",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000405701",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110160594",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4364105",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Seaford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.