Sean Joseph Wollaston, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A63797 Issued in CA

Practice address

12660 Riverside Dr
Suite 200
North Hollywood, CA 91607-3429

Phone

(818) 980-7010

Fax

(818) 980-7330

NPI assigned

Dec 5, 2005

Last updated

Sep 26, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Rheumatology

Education

New York Medical College, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center for Rheumatology Medical CorporationGroup PAC ID 2769651439, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sean.wollaston.1@3898.direct.athenahealth.com
• Direct secure messaging: sean.wollaston.p29@direct.aara1.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Rheumatology Medical Corporation

  • Rheumatology Physician
  • Los Angeles, CA
  • NPI 1982911160
  Medicare reassignment Care Compare group NPD
• Rheumatology Associates

  • Rheumatology Physician
  • North Hollywood, CA
  • NPI 1225208606
  Authorized official Same address or phone

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1316921075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "SUITE 200",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-980-7010",
            "fax_number": "818-980-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "SUITE 200",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-980-7010",
            "fax_number": "818-980-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLASTON",
        "first_name": "SEAN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A63797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Winter
• Katharine Winter, MASTERS OF EDUCATION
• Wisdom Willow Senior Living, Inc.
• Withers Chiropractic Inc
• Roy Regan Withers, D.C.
• Paola Wong, O.D.
• Siriporn Wongsoi
• Jocelyn Marlie Wood, MA, IMF
• David Woodard
• World Health Hospice, Inc

• Specialist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.
• 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.