Ilya Wolfson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

051860 Issued in GA

Practice address

3380 Trickum Rd BLDG 1000-102
Woodstock, GA 30188-3690

Phone

(770) 591-4777

Fax

(770) 591-4795

NPI assigned

Apr 1, 2006

Last updated

Jan 23, 2025By the provider in NPPES

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

Enrolled in GA

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

Family Practice

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Service Associates LLCGroup PAC ID 2860740297, 3 clinicians

Radiant Family Practice, LLCGroup PAC ID 5890977326, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: woodstockprimary@woodstockprimarycare.amazing-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ilya Wolfson M.D., Inc

  • Family Medicine Physician
  • Woodstock, GA
  • NPI 1275761025
  Medicare reassignment NPD Authorized official
• Radiant Family Practice LLC

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1326366154
  Medicare reassignment Care Compare group
• Medical Service Associates LLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1982112918
  Care Compare group Authorized official
• Endocrine Specialists of Georgia, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Cartersville, GA
  • NPI 1902407307
  NPD (past)
• Meredith Burns, Psy.D., P.C.

  • Clinical Psychologist
  • Woodstock, GA
  • NPI 1184753840
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1942261441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 TRICKUM RD BLDG 1000-102",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883690",
            "telephone_number": "770-591-4777",
            "fax_number": "770-591-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 TRICKUM RD BLDG 1000-102",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883690",
            "telephone_number": "770-591-4777",
            "fax_number": "770-591-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSON",
        "first_name": "ILYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "051860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fitsum Woldesellassie
• Nicole Marie Wolf, LPC
• Grant Collins Wolfe, M.D.
• Kelly R Wolfe
• Margaret Wolfe
• Virginia Nicole Woloski, LCSW
• Theasia Womack, RBT
• Vanessa C Womack, M.D.
• James Anthony Wombles Jr., ATC
• Women First Rehabilitation (Atlanta Pelvic Rehabilitation Specialists)

• Family Medicine Physician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.