Individual provider Active NPI

Steven Dana Wolff, M.D.PHD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1760410799
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
209638-1 Issued in NY
Practice address
170 East 77TH Street
Lower Level
New York, NY 10075-1912
Phone
(212) 369-9200
Fax
(212) 369-5408
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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 2096381 NY
Diagnostic Radiology Physician 2085R0202X 209638-1 NY Primary

Addresses

Primary practice location

170 East 77TH Street
Lower Level
New York, NY 10075-1912

Mailing address

170 E 77TH St
Lower Level
New York, NY 10075-1912
Phone (212) 369-9200

Other identifiers 1

IdentifierTypeStateIssuer
02140458MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623001220 NY Practitioner - Diagnostic Radiology 6305821281 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209638-1NYMDDiagnostic Radiology Physician
2096381NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Feb 9, 2019 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Feb 9, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients

Locations

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

622 W 168th St
#4100
New York, NY 10032
Phone (212) 305-5123

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1760410799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 77TH ST",
            "address_2": "LOWER LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751912",
            "telephone_number": "212-369-9200",
            "fax_number": "212-369-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 EAST 77TH STREET",
            "address_2": "LOWER LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751912",
            "telephone_number": "212-369-9200",
            "fax_number": "212-369-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "STEVEN",
        "middle_name": "DANA",
        "credential": "M.D.PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2096381",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "209638-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02140458",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.