Negga R. Wolderufael, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA12029 Issued in CA

Practice address

1411 E 31St St
Oakland, CA 94602-1018

Phone

(510) 437-4323

Fax

(510) 437-5042

NPI assigned

Nov 20, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Oakland, CA
  • NPI 1508874454
  NPD (past)
• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Berkeley, CA
  • NPI 1780692632
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1922289743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4323",
            "fax_number": "510-437-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4323",
            "fax_number": "510-437-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDERUFAEL",
        "first_name": "NEGGA",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA12029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Wofsy, MD
• Keri Wojcik
• Tomasz Wojcikiewicz, MD
• Jeffrey Wolcott
• Sara Woldemariam, MD
• Nahom Woldetsion
• Abigail Wolf, RN
• James Joseph Wolf, MFT
• Sarah Ellen Wolfarth-Davis, PHD, LMFT
• Uriel Isaac Wolfe-Blank, LMFT

• Surgical Physician Assistant in Oakland, CA
• Providers in Oakland, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.