Jeffrey R Wozniak, PHD

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

LP4183 Issued in MN

Practice address

2312 Sout 6TH Street
Suite F256 / 2B W
Minneapolis, MN 55454

Phone

(612) 273-8700

NPI assigned

Oct 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Express Care

  dba Fairview Clinics Specialty

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  dba University of Minnesota Health Clinics and Surgery Center - Anesthesia

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Adult Mental Health Clinic/Center
  • St Louis Park, MN
  • NPI 1144368531
  NPD
• University of Minnesota Physicians

  dba Dental Clinic

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760578215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "address_2": "420 DELAWARE ST SE MMC292",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 SOUT 6TH STREET",
            "address_2": "SUITE F256 / 2B W",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-273-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "MN",
            "license": "LP4183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1022592",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "124385",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRVIEW",
            "identifier": "169466",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA - CHOICE",
            "identifier": "61-89892",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24G96WO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "90046",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP29901",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wound Company Provider Group, Inc.
• Wound Company Provider Group, P.a.
• Debisa Kenate Woyessa Sr.
• Tiffany Woynilko, RN
• Hannah Woytek
• Wraparound House Calls, LLC
• Paul Wratkowski, DO
• Olivia Grace Wray, MS,. CCC-SLP
• Penny M Wrbsky, NNP
• Abigail Rice Wren, NP

• Pediatric Neurodevelopmental Disabilities Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.