Iryna Wolberg, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704270392 Issued in MI

Practice address

4206 Pontiac Lake Rd
Waterford, MI 48328-1261

Phone

(248) 742-1638

NPI assigned

Jul 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Merion Square Road Medical PCGroup PAC ID 0446605422, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iryna.wolberg.1@7909.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/7909/brand/1/csg/1/fhir/r4

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.

• Merion Square Road Medical PC

  • Pain Clinic/Center
  • Dayton, OH
  • NPI 1942923123

  MI

  Medicare reassignment Care Compare group NPD
• Mazher Hussain MD, PC

  • Pain Medicine Physician
  • Rochester Hills, MI
  • NPI 1255581682
  Medicare reassignment NPD

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1609282565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281261",
            "telephone_number": "248-742-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281261",
            "telephone_number": "248-742-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBERG",
        "first_name": "IRYNA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704270392",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704270392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wiseman
• Carmen Sue Wisniewski
• Kimberly Wisser
• Nancy Woehlke, MA
• Bradford J Woelke, M.D.
• Kristin A Wolf, B.S., M.A.
• Mary Ann Wolfe
• Woodward Detroit CVS, L.L.C.
• Woodward Detroit CVS, L.L.C.
• Woodward Detroit CVS, L.L.C.

• Nurse Practitioner in Waterford, MI
• Providers in Waterford, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.