Individual provider Active NPI

Edward A Wolf III, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1619168598
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
N4209 Issued in TX
Practice address
4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640
Phone
(210) 477-9555
Fax
(210) 614-2180
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X N4209 TX Primary

Addresses

Primary practice location

4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640

Mailing address

PO Box 34717
San Antonio, TX 78265-4717
Phone (210) 615-1187

Other identifiers 1

IdentifierTypeStateIssuer
2070674-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090930000117 TX Practitioner - Anesthesiology 0042356362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tulane University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Cardiovascular AnesthesiaGroup PAC ID 1951839414, 12 clinicians

Practice addresses (Care Compare)

12446 W Ave
Suite 200
San Antonio, TX 78216-2530
Phone (210) 525-1668

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Cardiovascular Anesthesia Anesthesiology CurrentSince Dec 9, 2024 Accepting new patients

Locations

12446 West Ave
Ste 200
San Antonio, TX 78216
Phone (210) 690-0230

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

Organizations & group practices 1

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 3

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1619168598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34717",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782654717",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR",
            "address_2": "SUITE 3100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295640",
            "telephone_number": "210-477-9555",
            "fax_number": "210-614-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N4209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070674-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.