Thomas Gerard Wolf, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002549 Issued in MI

Practice address

602 Michigan Ave
Holland, MI 49423-4918

Phone

(616) 392-3824

Fax

(616) 494-5950

NPI assigned

Nov 9, 2005

Last updated

Feb 23, 2021By the provider in NPPES

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

Electronic endpoints 2

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

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Holland Hospital Hospital, Holland, MI, CCN 230072
• Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twolf52734@epic00.corewelldirect.org
• Direct secure messaging: twolf52734@epic00.shdirect.org

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.

• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West Pediatric Diabetes Education

  • Pediatric Endocrinology Physician
  • Grand Rapids, MI
  • NPI 1326599671
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• West Michigan Heart

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
  • NPI 1174504021

  Physician Assistant

  NPD (past)

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

• Holland Community Hospital

  dba Holland Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  Care Compare affiliation
• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Zeeland Community Hospital

  dba Corewell Health Zeeland Hospital

  • General Acute Care Hospital
  • Zeeland, MI
  • NPI 1275536344
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1629059480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-392-3824",
            "fax_number": "616-494-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "THOMAS",
        "middle_name": "GERARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twolf52734@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "602 Michigan Ave",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494234918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "602 Michigan Ave",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494234918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Duane Frank Wisk, D.O.
• Erin Wisniewski, FNP-C
• Philip C Wisniewski, DDS, FAGD, PC
• Jennie L Woehl, FNP
• Benjamin Woiwode, M.ED, BCBA
• Joel R Wolfe, M.D.
• Regina Ann Wolma
• Bethany Wolter, BSN, RN, CDE
• Kaylin Wolter, DMD
• Wolters Chiropractic PLLC

• Physician Assistant in Holland, MI
• Providers in Holland, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.