Individual provider Active NPI

Michael Wolujewicz, MD

  • Diagnostic Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1730350299
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35120626 Issued in OH
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 962-2611
Fax
(513) 965-8091
NPI assigned
Mar 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35120626 OH Primary
Vascular & Interventional Radiology Physician 2085R0204X 46336 KY

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

PO Box 42456
Cincinnati, OH 45242-0456
Phone (513) 247-8646

Other identifiers 3

IdentifierTypeStateIssuer
7100229650MedicaidKY
201136350MedicaidIN
0078717MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130212000492 OH Practitioner - Diagnostic Radiology 2365696747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristate Img (Imaging Medical Group) IncGroup PAC ID 6204732365, 45 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone (513) 862-3710

110 N Poplar St
Oxford, OH 45056-1204
Phone (513) 569-6602

3125 Hamilton Mason Rd
Fairfield Township, OH 45011-5307
Phone (513) 894-8888

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 865-1331

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3710

740 W Galbraith Rd
Cincinnati, OH 45231-6002
Phone (513) 246-7000

7777 Beechmont Ave
Cincinnati, OH 45255-4209
Phone (513) 346-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46336KYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tristate Img (Imaging Medical Group) Inc CurrentSince Apr 1, 2014 Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

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 7

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": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1730350299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42456",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452420456",
            "telephone_number": "513-247-8646",
            "fax_number": "513-965-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-962-2611",
            "fax_number": "513-965-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLUJEWICZ",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-12",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35120626",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "46336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100229650",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201136350",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078717",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.