Active NPI
Edward G Wolfe, RPA
- Medical Physician Assistant
- Liverpool, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 004068
- Practice address
- 5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807 - Phone
- (315) 452-2333
- Fax
- (315) 452-2336
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0040681 | NY | |
| Physician Assistant | 363A00000X | |||
| Medical Physician Assistant | 363AM0700X | 004068 | NY | Primary |
Addresses
Primary practice location
5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807
Mailing address
5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807
Phone (315) 452-2333
Other practice location 1
739 Irving Ave Ste 200-300
Syracuse, NY 13210-1651
Phone (315) 479-5070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02366030 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
61 Delano St
Pulaski, NY 13142-1400
Phone (315) 298-6569
Hospital & facility affiliations
- Oswego Hospital
- Samaritan Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0040681 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Oswego County Health Services, Inc. | Current | Accepting new patients |
Locations
61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274
Interoperability endpoints
- ewolfe@hiemail.healtheconnections.org
- edward.wolfe@nochsi.directbygreenway.com
Organizations & group practices 3
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.
-
- Community Health Clinic/Center
- Pulaski, NY
- NPI 1508850280
-
- Orthopaedic Surgery Physician
- Syracuse, NY
- NPI 1669410379
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oswego, NY
- NPI 1871678458
-
- General Acute Care Hospital
- Watertown, NY
- NPI 1598713745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551139200000",
"number": "1669434536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 W TAFT RD",
"address_2": "SUITE 1C",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883807",
"telephone_number": "315-452-2333",
"fax_number": "315-452-2336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 W TAFT RD",
"address_2": "SUITE 1C",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883807",
"telephone_number": "315-452-2333",
"fax_number": "315-452-2336"
}
],
"practiceLocations": [
{
"address_1": "739 Irving Ave Ste 200-300",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "NY",
"postal_code": "132101651",
"country_code": "US",
"telephone_number": "315-479-5070",
"fax_number": "315-701-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLFE",
"first_name": "EDWARD",
"middle_name": "G",
"credential": "RPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2019-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "0040681",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "004068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02366030",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.