Individual provider Active NPI

Daniel Lawrence Wolfson, M.D.

  • Emergency Medicine Physician
  • Burlington, VT
National Provider Identifier
1710903521
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
42-0010433 Issued in VT
Practice address
111 Colchester Ave.
Fletcher Allen Health Care - Emergency Dept.
Burlington, VT 05401
Phone
(802) 847-1237
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 42-0010433 VT Primary

Addresses

Primary practice location

111 Colchester Ave.
Fletcher Allen Health Care - Emergency Dept.
Burlington, VT 05401

Mailing address

111 Colchester Ave.
Fletcher Allen Health Care - Emergency Dept.
Burlington, VT 05401
Phone (802) 847-1237

Other identifiers 2

IdentifierTypeStateIssuer
1009607MedicaidVT
E02379615MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20060426000256 VT Practitioner - Emergency Medicine 8729098454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Vermont College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42-0010433VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Emergency Medicine CurrentSince Dec 28, 2002 Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

528 Washington Hwy
Morrisville, VT 05661
Phone (802) 888-4231

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

Interoperability endpoints

  • Direct secure messaging: dwolfson3970@direct.uvmhealth.org

Organizations & group practices 1

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 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1710903521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE.",
            "address_2": "FLETCHER ALLEN HEALTH CARE - EMERGENCY DEPT.",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE.",
            "address_2": "FLETCHER ALLEN HEALTH CARE - EMERGENCY DEPT.",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSON",
        "first_name": "DANIEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "42-0010433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009607",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E02379615",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.