Individual provider Active NPI

Brian Joseph Wolter

  • Physician Assistant
  • Murrieta, CA
National Provider Identifier
1487053823
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1145 Issued in HI
Practice address
38725 Bears Paw Dr
Murrieta, CA 92562-3011
Phone
(951) 219-5105
NPI assigned
Aug 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-1145 HI Primary

Addresses

Primary practice location

38725 Bears Paw Dr
Murrieta, CA 92562-3011

Mailing address

38725 Bears Paw Dr
Murrieta, CA 92562-3011
Phone (951) 219-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220720003549 HI Practitioner - Physician Assistant 0244550283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

16 -523 Keaau Pahoa Rd
Keaau, HI 96749-8156
Phone (808) 932-3830

Hospital & facility affiliations

  • Kau Hospital Hospital, Pahala, HI, CCN 121301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52112CAMDGeneral Practice Dentistry
AMD-1145HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince May 22, 2024 Accepting new patients
Kau Hospital CurrentSince May 22, 2024 Accepting new patients
Kau Hospital Past Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

16-523 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 932-3801

Interoperability endpoints

  • Direct secure messaging: brian.wolter@340371529072644.direct.elationemr.com

Organizations & group practices 6

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 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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1487053823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38725 BEARS PAW DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925623011",
            "telephone_number": "951-219-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38725 BEARS PAW DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925623011",
            "telephone_number": "951-219-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTER",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.