Paul Douglass Wortman, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35791 Issued in NC

Practice address

127 S Poplar St
Winston Salem, NC 27101-3755

Phone

(336) 893-8423

Fax

(336) 893-8426

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Rutgers New Jersey Medical School, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8957/brand/1/csg/1/fhir/r4
• Direct secure messaging: paul.wortman.1@8957.direct.athenahealth.com

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.

• Mountainview Skin Care PC

  • Medical Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1649492232
  Medicare reassignment NPD Authorized official
• Piedmont Dermatology Center, PC

  • Specialist
  • Martinsville, VA
  • NPI 1538240486
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1932108461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S POPLAR ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013755",
            "telephone_number": "336-893-8423",
            "fax_number": "336-893-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S POPLAR ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013755",
            "telephone_number": "336-893-8423",
            "fax_number": "336-893-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "PAUL",
        "middle_name": "DOUGLASS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "35791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0300482",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00371225",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "89261",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E2611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "4521",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6309395",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8989261",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5975022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Worsley, MS, CCC
• Breanna Worthey
• Amber Faith Worthington
• Amy Elise Wortkoetter, PHARMD
• Joseph Daniel Wortman
• Wayne Joseph Wortmann III, MD
• WP-Winston-Salem Health Holdings, LLC
• Jillian Diane Wray, O.T.
• Walter Harrill Wray III, M.D.
• Ashley Marie Wren, LMBT

• Dermatology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.