Individual provider Active NPI

Vanessa Audrey Wolfman, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1356543367
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
245626 Issued in MA
Practice address
300 Longwood Ave
Children'S Hospital Boston Department of Medicine
Boston, MA 02115-5724
Phone
(617) 355-7793
Fax
(617) 739-0330
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LP01149 RI
Pediatrics Physician 208000000X 245626 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Children'S Hospital Boston Department of Medicine
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Children'S Hospital Boston Department of Medicine
Boston, MA 02115-5724
Phone (617) 355-7793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20180122002314 DC Practitioner - Emergency Medicine 8022377969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245626MAMDPediatrics Physician
LP01149RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Emergency Associates LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

Interoperability endpoints

  • Direct secure messaging: vwolfman428593@direct.hopkinsmedicine.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1356543367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "CHILDREN'S HOSPITAL BOSTON DEPARTMENT OF MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7793",
            "fax_number": "617-739-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "CHILDREN'S HOSPITAL BOSTON DEPARTMENT OF MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7793",
            "fax_number": "617-739-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFMAN",
        "first_name": "VANESSA",
        "middle_name": "AUDREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP01149",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "245626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.