Individual provider Active NPI

Mary M Wolfman, M.D.

  • Family Medicine Physician
  • Cambridge, MA
National Provider Identifier
1295891125
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37198 Issued in MA
Practice address
75 Mount Auburn St
Cambridge, MA 02138-4960
Phone
(617) 495-5711
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37198 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 495-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160505002241 MA Order and Referring Only - Family PracticePractitioner - Family Practice 6305145749

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37198MAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1295891125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFMAN",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "37198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.