Carl Wolnisty, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G5804 Issued in CA

Practice address

3838 Sherman Dr
Suite 7
Riverside, CA 92503-4001

Phone

(951) 688-5122

Fax

(951) 688-8145

NPI assigned

Jul 19, 2005

Reactivated

Mar 24, 2006

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Couture Medical Group Inc

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1134528987
  Medicare reassignment NPD

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1912906140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 7",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-688-5122",
            "fax_number": "951-688-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 7",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-688-5122",
            "fax_number": "951-688-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLNISTY",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-08-03",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G5804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID PTAN",
            "identifier": "CR238Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gage Wohlfield
• Hannah Wohlk
• Laura Wolack
• Anita Wolf, FNP
• Riley Wolf
• David Won
• Wonderkids Behavioral Services
• Alvin Cheuk Hay Wong, DO
• Brian A. Wong, MD
• Christine Wong, PHARMD

• Internal Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.