Laurie M Woll, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

20A4394 Issued in CA

Practice address

9301 Central Ave
#201
Montclair, CA 91763

Phone

(909) 621-5005

Fax

(909) 621-4900

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Dermatology

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.5 of 100Reported as group

Promoting interoperability

90

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Golden State Dermatology Associates, Inc.

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment Care Compare group NPD
• Laurie M. Woll, D.O., Dermatology, a Medical Corp

  • Specialist
  • Montclair, CA
  • NPI 1477740546
  Medicare reassignment Authorized official
• Golden State Dermatology Associates, Inc.

  • Ambulatory Surgical Clinic/Center
  • Fresno, CA
  • NPI 1235738576
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1891865044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 CENTRAL AVE",
            "address_2": "#201",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "91763",
            "telephone_number": "909-621-5005",
            "fax_number": "909-621-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 CENTRAL AVE",
            "address_2": "#201",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "91763",
            "telephone_number": "909-621-5005",
            "fax_number": "909-621-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLL",
        "first_name": "LAURIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A4394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaye Michelle Willingham
• Rosa I Winter, LCSW
• Eliana Adelyn Witke
• Amber Wolfe
• Faith Makenna Woll
• Patricia C Wollmer
• Jared Sze Wei Wong, M.D.
• Timothy J Wood, P.A.
• Amie Lynne Woods
• Shaunah Woods

• Dermatology Physician in Montclair, CA
• Providers in Montclair, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.