Paul W. Wolpert, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

3864 Issued in SD

Practice address

612 N Sioux Point Rd
Ste 400
Dakota Dunes, SD 57049-5088

Phone

(605) 232-6353

Fax

(605) 232-6500

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Paul W. Wolpert Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• General Surgery and Diagnostics PC

  • Surgery Physician
  • Dakota Dunes, SD
  • NPI 1003860594
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1497758718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N SIOUX POINT RD",
            "address_2": "STE 400",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495088",
            "telephone_number": "605-232-6353",
            "fax_number": "605-232-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N SIOUX POINT RD",
            "address_2": "STE 400",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495088",
            "telephone_number": "605-232-6353",
            "fax_number": "605-232-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPERT",
        "first_name": "PAUL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "3864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301600",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP RR MEDICARE",
            "identifier": "CN8257",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092460",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH DAKOTA LICENSE #",
            "identifier": "3864",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP RR MEDICARE",
            "identifier": "CP8566",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK  SOUTH DAKOTA",
            "identifier": "0003667",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA LICENSE NUMBER",
            "identifier": "11456",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE NUMBER",
            "identifier": "18017",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "WOLPERT",
            "middle_name": "W.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Faye M Winder, PA-C
• Amber L Wisner, DDS
• Seth Wolles, ATC
• John A Wolpert, M.D.
• Michael L. Wolpert, M.D.
• Andrea Elizabeth Wood, MSPT
• Angela Carole Woodall
• Connie Alison Zimmerman, LPN
• Robert G Zimmerman, M.D.

• Surgery Physician in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.