Individual provider Active NPI

Holly K. Wyneski, M.D.

  • Urology Physician
  • Wooster, OH
National Provider Identifier
1467642496
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35090889 Issued in OH
Practice address
1761 Beall Ave Ste 103
Wooster, OH 44691-2342
Phone
(330) 263-8733
Fax
(330) 263-8732
NPI assigned
Jul 26, 2007
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35090889 OH Primary

Addresses

Primary practice location

1761 Beall Ave Ste 103
Wooster, OH 44691-2342

Mailing address

1761 Beall Ave
Wooster, OH 44691-2342
Phone (330) 263-8733

Other identifiers 1

IdentifierTypeStateIssuer
2842526MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080507000077 OH Practitioner - Urology 7315026028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northeastern Ohio University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Practice addresses (Care Compare)

1761 Beall Ave
Wooster, OH 44691-2342

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.17 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
33.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35090889OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Kay Wyneski MD, LLC Urology CurrentSince Mar 1, 2017 Accepting new patients
Bloomington Medical Services LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

128 E Milltown Rd
Ste 205
Wooster, OH 44691
Phone (330) 345-2008

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

1761 Beall Ave
Ste 103
Wooster, OH 44691
Phone (330) 202-5662

Interoperability endpoints

  • Direct secure messaging: holly.wyneski@413532193095684.direct.elationemr.com
  • Direct secure messaging: hwyneski560506@ehrdirect.uhhospitals.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1467642496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-263-8733",
            "fax_number": "330-263-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 103",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-263-8733",
            "fax_number": "330-263-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNESKI",
        "first_name": "HOLLY",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35090889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2842526",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.