Michael T Woodall, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101281752 Issued in VA

Practice address

777 Park Ave W
Highland Park, IL 60035-2433

Phone

(847) 926-5840

Fax

(847) 926-5835

NPI assigned

Apr 30, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, VA2 enrollments

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 2

Specialty

Pediatric Medicine

Education

University of Alabama School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwoodall637125@direct.healthsystem.virginia.edu

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Pediatrics

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1952788747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-926-5840",
            "fax_number": "847-926-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-926-5840",
            "fax_number": "847-926-5835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011700",
            "country_code": "US",
            "telephone_number": "847-570-2833",
            "fax_number": "847-570-1510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082433",
            "country_code": "US",
            "telephone_number": "195-278-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301107864",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036155855",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101281752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wolfson Psychological Services, P.C.
• Ivan A. Wolfson, PSY.D.
• Wayne Wolkowicz, REGISTERED NURSE
• Wendy Wong
• Meredith Wood, L.M.F.T
• Lisa Beth Woods, M.S., CCC-SLP
• Frank J. Woolman, D.D.S.
• David Michael Woosencraft, M.D.
• Judith Gail Yacker, M.S., CCC-SLP/L
• Sarah Yang

• Pediatrics Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.