Craig Bryan Woda, M.D., PH.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LP01110 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-8450

Fax

(401) 444-5088

NPI assigned

Jun 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in MA, CT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwoda44011@direct.capecodhealthcare.masshiway.net
• Direct secure messaging: cwoda106731@umassmemorial.direct-ci.com
• Direct secure messaging: cwoda19804@direct.southcoast.org
• Direct secure messaging: cwoda51926@connecticutchildrens.direct-ci.com

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.

• Children'S Hospital Pediatric Associates, Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1457306664
  Medicare reassignment NPD
• Connecticut Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882

  MA

  Medicare reassignment NPD
• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  NPD
• Connecticut Children'S Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984

  Pediatrics

  NPD

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1811199821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9395",
            "fax_number": "860-545-8422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WODA",
        "first_name": "CRAIG",
        "middle_name": "BRYAN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "243278",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP01110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwoda106731@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwoda51926@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Agnieszka Witkowska, M.D.
• Athena Leah Witscher
• Edward Gerard Wittels, MD
• Emily Joanne Witter
• Danielle M Wladyszewski, LICSW
• Margaret Wogbeh, RN
• Kyle Joseph Wohlrab, MD
• Edward J Wojciechowski, PT
• Patricia Neely Wold, MD
• Betelhem Gebremichel Woldemariam

• Pediatrics Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.