Individual provider Active NPI

Peter Wolfenberger

  • Anesthesiologist Assistant
  • Springfield, GA
National Provider Identifier
1487023529
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
459 Highway 119 S
Springfield, GA 31329-3021
Phone
(912) 754-0433
NPI assigned
Sep 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

459 Highway 119 S
Springfield, GA 31329-3021

Mailing address

400 Mall Blvd
Suite T
Savannah, GA 31406-4861
Phone (912) 355-7214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MO, OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160203001622 GA Practitioner - Anesthesiology Assistant 7315241817 Reassigns benefits to 1 organization
I20201029000643 MO Practitioner - Anesthesiology Assistant 7315241817 Reassigns benefits to 1 organization
I20230929000301 OK Practitioner - Anesthesiology Assistant 7315241817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

3300 NW Expressway St
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesiology Associates, Inc. CurrentSince Jul 28, 2020 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Mar 16, 2016 Accepting new patients
Anesthesia Medical Professionals, PLLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1487023529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MALL BLVD",
            "address_2": "SUITE T",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064861",
            "telephone_number": "912-355-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-754-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFENBERGER",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.