Active NPI
Alejandro J. Wolf, D.O.
- Anatomic Pathology & Clinical Pathology Physician
- Clovis, CA
National Provider Identifier
1962885764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 20A22912
- Practice address
- 305 Park Creek Dr
Clovis, CA 93611-4426 - Phone
- (559) 326-2800
- Fax
- (559) 326-2801
- NPI assigned
- Jun 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 12213186-1204 | UT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | WA | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 20A22912 | CA | Primary |
Addresses
Primary practice location
305 Park Creek Dr
Clovis, CA 93611-4426
Mailing address
7703 Navarro View CT
Midvale, UT 84047-4864
Phone (825) 966-6573
Other practice location 1
983135 Nebraska Medical Ctr
Omaha, NE 68198-1471
Phone (402) 559-4186
Other practice location 2
111 University Pkwy
Yakima, WA 98901-1471
Phone (509) 452-5100
Other practice location 3
15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100
Phone (801) 587-4563
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240904001137 | CA | Practitioner - Pathology | 1355615469 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
305 Park Creek Dr
Clovis, CA 93611-4426
Phone (559) 326-2800
Hospital & facility affiliations
- Clovis Community Medical Center
- Community Regional Medical Center
- Adventist Health Hanford
- Fresno Surgical Hospital
- Adventist Health Tulare
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A22912 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
| 22912 | CA | MD | Certified Respiratory Therapist |
Organizations & group practices 1
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.
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
Hospital
-
- General Acute Care Hospital
- Clovis, CA
- NPI 1316027709
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1962885764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7703 NAVARRO VIEW CT",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840474864",
"telephone_number": "825-966-6573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 PARK CREEK DR",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936114426",
"telephone_number": "559-326-2800",
"fax_number": "559-326-2801"
}
],
"practiceLocations": [
{
"address_1": "983135 Nebraska Medical Ctr",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681981471",
"country_code": "US",
"telephone_number": "402-559-4186",
"fax_number": "402-559-6018",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 University Pkwy",
"address_purpose": "LOCATION",
"city": "Yakima",
"state": "WA",
"postal_code": "989011471",
"country_code": "US",
"telephone_number": "509-452-5100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15 N Medical Dr Ste 1100",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841121100",
"country_code": "US",
"telephone_number": "801-587-4563",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLF",
"first_name": "ALEJANDRO",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-30",
"last_updated": "2024-05-29",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "UT",
"license": "12213186-1204",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "20A22912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.