ELYSE WOLF (APN) – Family Medicine Physician, NPI 1629738661

ELYSE WOLF (APN) is a healthcare provider. based in Annawan, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 041361562 (IL). The NPI Number for ELYSE WOLF (APN) is 1629738661

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
ELYSE WOLF (APN)
NPI
1629738661
Phone
(309) 507-0064
Address
205 TAMAROA TRL
Enumeration Date
17 December 2021
Last Update Date
17 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3099354100
Graduation Year
2021 (5 years ago)
PAC ID
8820483340
Group Practice PAC ID
0143115949
Professional Enrollment ID
I20220321001279
Address ID
IL612347756AN203XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for ELYSE WOLF (APN)

  • 205 TAMAROA TRL

    ANNAWAN, IL 612349707

    Phone: (309) 507-0064

    Type: Mailing

  • 600 N COLLEGE AVE

    GENESEO, IL 612541091

    Phone: (309) 944-6431

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 121 Open Payments records for all available years, with a total value of $2,270.

Total Amount is formed as General ($2,270) + Research ($0) + Ownership ($0) = $2,270.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($449).

Total Amount

$2,270

General + Research + Ownership

Payments

121

Total payment records

General Amount

$2,270

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220321001279INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61234)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143115949View full group profile
NameSpecialtyState
Family PracticeIL
Family PracticeIL
Certified Registered Nurse Anesthetist (Crna)IA
Nurse PractitionerIA
C H I R O P R A C T I CIL
Nurse PractitionerIL
Physician AssistantIL
Internal Medicine, RheumatologyIL
Orthopedic SurgeryWI
C H I R O P R A C T I CIL

Reviews

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Frequently asked questions

What unique ID ties claims to ELYSE WOLF (APN)?
NPI 1629738661 is assigned to ELYSE WOLF (APN) under the national enumeration system.
Is ELYSE WOLF (APN)'s NPI currently valid?
The extract we use shows ELYSE WOLF (APN) as active.
Does ELYSE WOLF (APN) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for ELYSE WOLF (APN). Clinical services aligned with this taxonomy classification.
What location metadata exists for ELYSE WOLF (APN)?
The page summarizes Annawan, Illinois for ELYSE WOLF (APN); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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