Individual provider Active NPI

Taylor Charlotte Wolfgang, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1639660558
Registry record updated May 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
275600 Issued in MA
Practice address
755 Washington St
Boston, MA 02111-1520
Phone
(617) 636-8100
NPI assigned
May 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 275600 MA Primary

Addresses

Primary practice location

755 Washington St
Boston, MA 02111-1520

Mailing address

1600 Beacon St Apt 703
Brookline, MA 02446-2228
Phone (802) 793-2865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20231101001127 OR Practitioner - Internal MedicinePractitioner - Rheumatology 5597012690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Rheumatology
Education
University of Vermont College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 155
Portland, OR 97213-2956
Phone (503) 215-6819

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 29, 2023 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 29, 2023 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 29, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2023 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 1, 2023 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 29, 2023 Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1510 Division St
Ste 170
Oregon City, OR 97045
Phone (503) 215-6819

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 155
Portland, OR 97213
Phone (503) 215-6819

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: twolfgang3015937@oc.providencedirect.org

Organizations & group practices 7

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": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527292800000",
    "number": "1639660558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BEACON ST APT 703",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462228",
            "telephone_number": "802-793-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111520",
            "telephone_number": "617-636-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFGANG",
        "first_name": "TAYLOR",
        "middle_name": "CHARLOTTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-26",
        "last_updated": "2018-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "275600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.