Individual provider Active NPI

Joseph Allen Wolf, M.D.

  • Plastic Surgery Physician
  • Lawrence, NY
National Provider Identifier
1366657199
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
216232 Issued in NY
Practice address
91 Merrall Dr
Lawrence, NY 11559-1518
Phone
(917) 797-3220
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 216232 NY Primary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 216232 NY
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 216232 NY
Plastic and Reconstructive Surgery Physician 2086S0122X 216232 NY

Addresses

Primary practice location

91 Merrall Dr
Lawrence, NY 11559-1518

Mailing address

91 Merrall Dr
Lawrence, NY 11559-1518
Phone (917) 797-3220

Other identifiers 1

IdentifierTypeStateIssuer
2038K1OtherNYBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040325000896 NY Practitioner - Plastic and Reconstructive SurgeryPractitioner - DermatologyPractitioner - Internal Medicine 4981596053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph a Wolf, MD PC Plastic Surgery CurrentSince Apr 6, 2009 Accepting new patients
A. Joshua Zimm MD, P.C. PastSince Aug 12, 2012 Accepting new patients

Locations

1122 Broadway
Woodmere, NY 11598
Phone (516) 295-3838

Organizations & group practices 2

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1366657199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MERRALL DR",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591518",
            "telephone_number": "917-797-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MERRALL DR",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591518",
            "telephone_number": "917-797-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JOSEPH",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "216232",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "216232",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "216232",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "216232",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2038K1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.