Individual provider Active NPI

Mitchell Wolfson, MD

  • Cardiovascular Disease Physician
  • Roslyn, NY
National Provider Identifier
1457377665
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
135548 Issued in NY
Practice address
804 Mill CRK N
Roslyn, NY 11576-1647
Phone
(914) 484-6051
Fax
(516) 706-0331
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 135548 NY Primary

Addresses

Primary practice location

804 Mill CRK N
Roslyn, NY 11576-1647

Mailing address

804 Mill CRK N
Roslyn, NY 11576-1647
Phone (914) 484-6051

Other identifiers 1

IdentifierTypeStateIssuer
00783555MedicaidNY

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
I20041222000369 NY Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5092616680 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Current Accepting new patients
Park Avenue Medical Associates LLC PastSince Mar 2, 2009 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Organizations & group practices 4

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1457377665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 MILL CRK N",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761647",
            "telephone_number": "914-484-6051",
            "fax_number": "516-706-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 MILL CRK N",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761647",
            "telephone_number": "914-484-6051",
            "fax_number": "516-706-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSON",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "135548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783555",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.