Active NPI
Denise Wolken, M.D.
- Pediatrics Physician
- Fayetteville, NY
National Provider Identifier
1356361646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 190114
- Practice address
- 4000 Medical Center Dr
Suite 214
Fayetteville, NY 13066-6617 - Phone
- (315) 991-4180
- Fax
- (315) 991-4046
- NPI assigned
- Jul 20, 2006
- Last updated
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 190114 | NY | Primary |
Addresses
Primary practice location
4000 Medical Center Dr
Suite 214
Fayetteville, NY 13066-6617
Mailing address
4000 Medical Center Dr
Suite 214
Fayetteville, NY 13066-6617
Phone (315) 991-4180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190114 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denise C. Wolken, MD PLLC | Pediatrics | Current | Accepting new patients |
Locations
4000 Medical Center Dr
Ste 214
Fayetteville, NY 13066
Phone (315) 329-4968
6851 E Genesee St
Fayetteville, NY 13066
Phone (315) 446-4580
Interoperability endpoints
- drwolken@wolkenpeds.opdirect.net
- dwolken@hiemail.healtheconnections.org
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Fayetteville, NY
- NPI 1225541022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1356361646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MEDICAL CENTER DR",
"address_2": "SUITE 214",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130666617",
"telephone_number": "315-991-4180",
"fax_number": "315-991-4046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 MEDICAL CENTER DR",
"address_2": "SUITE 214",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130666617",
"telephone_number": "315-991-4180",
"fax_number": "315-991-4046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLKEN",
"first_name": "DENISE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2024-07-01",
"certification_date": "2024-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "190114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NY
- William Wojnowicz, RPH
- Sarah Dyanne Wolf-Gramzow, LMFT, PHD
- Emily Mariah Wolf, LMHC
- Megan Wolfe, NP
- Robert George Wolfe III, PT
- Wolverine Hearing Group, LLC
- Christian Haglund Woodhead, DDS
- Word Wellness Center, LLC (Word Wholeness Center)
- Jacqueline N. Wright, PT
- Deborah Jane Yannascoli, MA, RD, CDN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.