Amy Wolff Vidnovic, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

PENDING Issued in MA

Practice address

7 Alfred St Ste 220
Woburn, MA 01801-1939

Phone

(781) 933-6236

NPI assigned

Jul 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Elizabeth Wolff Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: avidnovic33403@direct.chppoc.masshiway.net

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.

• Woburn Pediatric Associates

  • Pediatrics Physician
  • Woburn, MA
  • NPI 1124136510
  NPD (past)

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1730852807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WAYLAND AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064664",
            "telephone_number": "914-960-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ALFRED ST STE 220",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011939",
            "telephone_number": "781-933-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDNOVIC",
        "first_name": "AMY",
        "middle_name": "WOLFF",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WOLFF",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in Woburn, MA
• Providers in Woburn, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.