Michael Wolterbeek, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E4215 Issued in CA

Practice address

609 E Orangeburg Ave
Suite 201
Modesto, CA 95350-5580

Phone

(209) 572-3613

Fax

(209) 572-4528

NPI assigned

Aug 12, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stanislaus Orthopaedic and Sports Medicine ClinicGroup PAC ID 0042373862, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Medical Center Hospital, Modesto, CA, CCN 050464

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stanislaus Orthopaedic and Sports Medicine Clinic

  • Specialist
  • Modesto, CA
  • NPI 1669505160
  Medicare reassignment Care Compare group
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Physicians Surgery Center of Modesto LLC

  • Ambulatory Surgical Clinic/Center
  • Modesto, CA
  • NPI 1538280284
  NPD (past)

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

• Doctors Medical Center of Modesto, Inc.

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  Care Compare affiliation

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497767396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "address_2": "SUITE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505580",
            "telephone_number": "209-572-3613",
            "fax_number": "209-572-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "address_2": "SUITE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505580",
            "telephone_number": "209-572-3613",
            "fax_number": "209-572-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERBEEK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E42150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tristan Lorenzo Wolf
• Alexandra Wolff, BCBA
• Karran Kirkle Wolff, RN
• Maureen Wolff
• Tamy Marie Wolk, MS
• Brittany Anna Womack
• Peter C. Wonder, NP
• Anna Pon Wong, PHARM.D.
• Cheng Yi Wong, RD
• Elaine H Wong, MD

• Podiatrist in Modesto, CA
• Providers in Modesto, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.