Organization Active NPI

Worcester Urological Associates Inc

  • Urology Physician
  • Worcester, MA
National Provider Identifier
1285634782
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
WORCESTER UROLOGICAL ASSOCIATES INC
Practice address
25 Oak Avenue
Worcester, MA 01605
Phone
(508) 756-6293
Fax
(508) 756-9404
NPI assigned
Jul 26, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michael R Wollin, MDNPI 1750381836
Title
President
Phone
(508) 756-6293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MA
Urology Physician 208800000X Primary

Addresses

Primary practice location

25 Oak Avenue
Worcester, MA 01605

Mailing address

25 Oak Avenue
Worcester, MA 01605
Phone (508) 756-6293

Other identifiers 2

IdentifierTypeStateIssuer
9701087MedicaidMA
81612175MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040806000901 MA Part B Supplier - Clinic/Group Practice 1456323864 Receives reassigned benefits from 4 practitioners
Practice locations: Worcester, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0069788Worcester Urological Associates25 Oak Avenue, Worcester, MA 01605Provider-performed microscopyJun 5, 2027

National Provider Directory

National Provider Directory

Locations

25 Oak Ave
Ste 2
Worcester, MA 01605
Phone (508) 756-6293

Interoperability endpoints

  • Direct secure messaging: michaelwollin@wua.medalliesdirect.net
  • Direct secure messaging: philipayvazian@wua.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285634782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 OAK AVENUE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-756-6293",
            "fax_number": "508-756-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 OAK AVENUE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-756-6293",
            "fax_number": "508-756-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORCESTER UROLOGICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOLLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-756-6293",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9701087",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81612175",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.