Organization Active NPI

Lisa Woolf , M.D., a Professional Corporation

  • Dermatology Physician
  • Westlake Village, CA
National Provider Identifier
1851459663
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A69234 Issued in CA
Legal business name
LISA WOOLF , M.D., A PROFESSIONAL CORPORATION
Practice address
32144 Agoura Rd
Ste 202
Westlake Village, CA 91361-4048
Phone
(818) 991-5551
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Pattye Olmack
Title
Billing Office
Phone
(818) 879-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X A69234 CA Primary

Addresses

Primary practice location

32144 Agoura Rd
Ste 202
Westlake Village, CA 91361-4048

Mailing address

32144 Agoura Rd
Ste 202
Westlake Village, CA 91361-4048
Phone (818) 991-5551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090320000262 CA Part B Supplier - Clinic/Group Practice 0941367866 Receives reassigned benefits from 1 practitioner
Practice locations: Westlake Village, CA

National Provider Directory

National Provider Directory

Locations

32144 Agoura Rd
Ste 202
Westlake Village, CA 91361
Phone (818) 991-5551

1250 La Venta Dr
Ste 213
Westlake Village, CA 91361
Phone (805) 497-2772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1851459663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "STE 202",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614048",
            "telephone_number": "818-991-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "STE 202",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614048",
            "telephone_number": "818-991-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA WOOLF , M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "OLMACK",
        "authorized_official_first_name": "PATTYE",
        "authorized_official_title_or_position": "BILLING OFFICE",
        "authorized_official_telephone_number": "818-879-1935"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A69234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.