Individual provider Active NPI

Michael Marc Wolz, MBCHB

  • Dermatology Physician
  • Duluth, MN
National Provider Identifier
1689986291
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
55516 Issued in MN
Practice address
400 East Third Street
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jul 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 55516 MN Primary

Addresses

Primary practice location

400 East Third Street
Essentia Health Duluth Clinic
Duluth, MN 55805-1951

Mailing address

400 East Third Street
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 1

IdentifierTypeStateIssuer
P01229380OtherMNMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120905000513 MN Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2466609979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision86
Removal of skin lesions585
Removal of skin cancer455
Removal or shaving of skin growth1-10
Skin biopsy353

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD CurrentSince Sep 22, 2014 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Sep 22, 2014 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Duluth Graduate Medical Education Council Inc PastSince Jul 24, 2022 Accepting new patients

Locations

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

Organizations & group practices 5

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 4

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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689986291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLZ",
        "first_name": "MICHAEL",
        "middle_name": "MARC",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "55516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01229380",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.