Kelley Marie Dasovich Wolff, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

AMD-290 Issued in HI

Practice address

5801 Army Pentagon
Washington, DC 20310-5001

Phone

(703) 692-8928

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1346372729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "703-692-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 ARMY PENTAGON",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203105001",
            "telephone_number": "703-692-8928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_2": "Tripler Army Medical Center ATTN MCHK QS",
            "address_purpose": "LOCATION",
            "city": "Tamc",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "KELLEY",
        "middle_name": "MARIE DASOVICH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003223",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Wolfe, LICSW
• Keisha Dale Wolfe, DO
• Kimberly J Wolfe, LICSW/LCSW-C
• Penny Leigh Wolfe, PH.D.
• Jean Wolff, NP
• Steven Joel Wolin, M.D.
• Angelyn Wollen, LMSW
• Susan Wollersheim, MD
• Wolomi, Inc
• Karelle Wolongwooh

• Medical Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Medical Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.

Verify at the official NPI Registry.