Individual provider Active NPI

Dylan Ned Wolman, M.D.

  • Vascular & Interventional Radiology Physician
  • Providence, RI
National Provider Identifier
1265828081
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD19449 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4000
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD208113 OR
Vascular & Interventional Radiology Physician 2085R0204X 1017009 MA
Vascular & Interventional Radiology Physician 2085R0204X MD19449 RI Primary
Diagnostic Radiology Physician 2085R0202X MD19449 RI

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-0990

Other practice location 2

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230821003354 RI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7012348600 Reassigns benefits to 3 organizations
I20231017003109 MA Practitioner - Diagnostic Radiology 7012348600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Medical Imaging IncGroup PAC ID 8022097815, shared by 2 NPIs, 107 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19449RIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Rhode Island Hospital CurrentSince Oct 1, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Aug 13, 2023 Accepting new patients
Rhode Island Hospital CurrentSince Oct 1, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

60 Messenger St
Plainville, MA 02762
Phone (508) 695-0055

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
#6
Providence, RI 02903
Phone (401) 793-9166

593 Eddy St
Providence, RI 02903

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

593 Eddy St
Bldg 2ND
Providence, RI 02903
Phone (401) 444-4076

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 8

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1265828081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-418-0990",
            "fax_number": "503-494-4982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033143",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLMAN",
        "first_name": "DYLAN",
        "middle_name": "NED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OR",
            "license": "MD208113",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "1017009",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "RI",
            "license": "MD19449",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD19449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.