Individual provider Active NPI

Stewart I Wolfe, O,D.

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1649293192
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7090 Issued in CA
Practice address
720 4TH St
Santa Rosa, CA 95404-4421
Phone
(707) 557-3800
Fax
(707) 528-4967
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7090 CA Primary

Addresses

Primary practice location

720 4TH St
Santa Rosa, CA 95404-4421

Mailing address

720 4TH St
Santa Rosa, CA 95404-4421
Phone (707) 575-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1649293192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044421",
            "telephone_number": "707-575-3800",
            "fax_number": "707-528-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044421",
            "telephone_number": "707-557-3800",
            "fax_number": "707-528-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "STEWART",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "O,D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.