Individual provider Active NPI

Andrew John Wodowski, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Memphis, TN
National Provider Identifier
1518226398
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
57286 Issued in TN
Practice address
6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023
Phone
(901) 641-3000
Fax
(901) 701-2400
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 57286 TN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 57286 TN Primary

Addresses

Primary practice location

6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023

Mailing address

6077 Primacy Pkwy
Ste 140
Memphis, TN 38119-5742
Phone (901) 725-8347

Other practice location 1

7580 Clarington Cv
Southaven, MS 38671-5657
Phone (901) 641-3000

Other practice location 2

2100 Exeter Rd Ste 200
Germantown, TN 38138-3966
Phone (901) 641-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180928001847 MS Practitioner - Orthopedic Surgery 0941446611 Reassigns benefits to 1 organization
I20181019002653 TN Practitioner - Orthopedic Surgery 0941446611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, shared by 10 NPIs, 138 clinicians

Practice addresses (Care Compare)

6286 Briarcrest Ave
Suite 200
Memphis, TN 38120-4023
Phone (901) 641-3000

7580 Clarington CV
Southaven, MS 38671-5657
Phone (901) 259-1600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement55
Knee replacement89
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57286TNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group PC Orthopaedic Surgery CurrentSince Aug 1, 2018 Accepting new patients
St Jude Children'S Research Hospital, Inc. CurrentSince Nov 4, 2023 Accepting new patients
MSK Group, PC Orthopaedic Surgery CurrentSince Aug 1, 2018 Accepting new patients
MSK Group, PC Orthopaedic Surgery CurrentSince Aug 1, 2018 Accepting new patients

Locations

2670 McIngvale Rd
Ste J
Hernando, MS 38632
Phone (662) 548-2710

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

8010 Stage Hills Blvd
Bartlett, TN 38133
Phone (901) 937-3200

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

6286 Briarcrest Ave
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 200
Memphis, TN 38120
Phone (901) 259-1600

Interoperability endpoints

  • Direct secure messaging: awodowski23020@mlh.direct-ci.com

Organizations & group practices 4

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 5

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": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1518226398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY",
            "address_2": "STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195742",
            "telephone_number": "901-725-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6286 BRIARCREST AVE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204023",
            "telephone_number": "901-641-3000",
            "fax_number": "901-701-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Clarington Cv",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715657",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-701-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-373-0804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WODOWSKI",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "57286",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "57286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.