Individual provider Active NPI

Daniel Arthur Wollin, M.D.

  • Urology Physician
  • West Roxbury, MA
National Provider Identifier
1629360714
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
276922 Issued in MA
Practice address
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone
(617) 323-7700
NPI assigned
May 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2016-00676 NC
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 276922 MA Primary

Addresses

Primary practice location

1400 VFW Pkwy
West Roxbury, MA 02132-4927

Mailing address

PO Box 63362
Charlotte, NC 28263-3362
Phone (800) 782-6945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20191010000181 MA Practitioner - Urology 6507154903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Chicago, Pritzker School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3586

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-00676NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Oct 1, 2019 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

1153 Centre St
#L1
Jamaica Plain, MA 02130

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Interoperability endpoints

  • Direct secure messaging: wollin.daniel.bwh@direct.partners.masshiway.net

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 6

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": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1629360714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362",
            "telephone_number": "800-782-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "617-323-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLIN",
        "first_name": "DANIEL",
        "middle_name": "ARTHUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-06",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2016-00676",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "276922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.