Individual provider Active NPI

Michael Glenn Wolford, D.O.

  • Emergency Medicine Physician
  • Tequesta, FL
National Provider Identifier
1508805284
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS9197 Issued in FL
Practice address
200 Waterway Rd
Tequesta, FL 33469-2764
Phone
(561) 422-7334
NPI assigned
Jun 6, 2006
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102201564 VA
Emergency Medicine Physician 207P00000X OS007470L PA
Emergency Medicine Physician 207P00000X OS9197 FL Primary

Addresses

Primary practice location

200 Waterway Rd
Tequesta, FL 33469-2764

Mailing address

200 Waterway Rd Apt 104
Tequesta, FL 33469-2752
Phone (561) 524-5871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041013000910 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 2769442888 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecnb LLCGroup PAC ID 7911959341, 28 clinicians

Practice addresses (Care Compare)

2720 10TH Ave N
Suite 100
Lake Worth, FL 33461-3100
Phone (561) 540-4446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201564VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Dec 1, 2012 Accepting new patients
Mecnb, LLC CurrentSince May 19, 2025 Accepting new patients
Treasure Coast Medical Associates Emergency Medicine CurrentSince Mar 21, 2011 Accepting new patients
Mecnb, LLC CurrentSince May 19, 2025 Accepting new patients
Treasure Coast Medical Associates Emergency Medicine CurrentSince Mar 21, 2011 Accepting new patients
Sidney Emergency Physicians, Inc. Emergency Medicine Past Accepting new patients
Okeechobee Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Knox Emergency Services, LLC Emergency Medicine Past Accepting new patients

Locations

525 S Federal Hwy
Deerfield Beach, FL 33441
Phone (954) 421-8181

3405 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 692-8082

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

305 NE Park St
Okeechobee, FL 34972
Phone (772) 692-8082

2720 10th Ave N
Ste 100
Palm Springs, FL 33461
Phone (561) 540-4446

1607 NW Federal Hwy
Ste B
Stuart, FL 34994
Phone (772) 692-8082

6515 S Kanner Hwy
Stuart, FL 34997
Phone (772) 463-1123

225 S US Highway 1
Tequesta, FL 33469
Phone (561) 747-4464

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1508805284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WATERWAY RD APT 104",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692752",
            "telephone_number": "561-524-5871",
            "fax_number": "561-746-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WATERWAY RD",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692764",
            "telephone_number": "561-422-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "MICHAEL",
        "middle_name": "GLENN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102201564",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS007470L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS9197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tequesta, FL

Sources for this page

Verify at the official NPI Registry.