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Benjamin Jonathan Wolpaw

Hospitalist

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as BENJAMIN WOLPAW.

Based on the most recent information from CMS, provider Benjamin Jonathan Wolpaw is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1710371646
Provider Type
Individual
Full Name
Wolpaw, Benjamin Jonathan
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/28/2015
Last Updated
7/1/2019

Contact Information

Practice Location

325 9th Ave, Seattle, WA 98104-2420

(206) 520-5000

Unlisted Fax

Mailing Location

1959 NE Pacific St Rm Bb-527, Box 356421, Seattle, WA 98195-6421

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License MD60766924 Washington
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License MD60766924 Washington

Provider Identifiers

ID	Description	Issuer
ID 1710371646	Description Medicaid	Issuer Unlisted Washington

Benjamin Jonathan Wolpaw

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Yousufzai, Hasib

Jensen, Kelly Elysia

Mattes, Zachary Charles

Law, Sidney

Matsumoto, Kim M

Korinke, Erika Rene

Abid, Bushra

Deslauriers, Nicholas Reid

Rajashekara, Shruthi

Cho, Alvin Rim