Individual provider Active NPI

Robert Wlodarski, M.D.

  • Vascular & Interventional Radiology Physician
  • Dearborn, MI
National Provider Identifier
1841591617
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
4301096872 Issued in MI
Practice address
840 Oakwood Blvd
Dearborn, MI 48124-2319
Phone
(313) 359-7600
Fax
(313) 359-7678
NPI assigned
Nov 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 4301096872 MI
Vascular & Interventional Radiology Physician 2085R0204X 4301096872 MI Primary

Addresses

Primary practice location

840 Oakwood Blvd
Dearborn, MI 48124-2319

Mailing address

PO Box 2802
Dearborn, MI 48123-2929
Phone (313) 359-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20160726002527 IL Practitioner - Diagnostic Radiology 1951603448 Reassigns benefits to 2 organizations
I20260206002336 IN Practitioner - Diagnostic Radiology 1951603448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians

Practice addresses (Care Compare)

1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 757-6320

905 W Washington Ave
Lake Bluff, IL 60044-1647
Phone (219) 767-6320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301096872MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists in Medical Imaging SC Diagnostic Radiology CurrentSince Oct 23, 2020 Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Dec 24, 2022 Accepting new patients
Oakwood Healthcare Inc Past Accepting new patients

Locations

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

Organizations & group practices 3

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 5

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": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841591617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2802",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481232929",
            "telephone_number": "313-359-7600",
            "fax_number": "313-359-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242319",
            "telephone_number": "313-359-7600",
            "fax_number": "313-359-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLODARSKI",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301096872",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301096872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.