NICOLE WOLF – Physician Assistant, NPI 1104365014

NICOLE WOLF is a healthcare provider. based in Sault sainte marie, Michigan. specializing in PHYSICIAN ASSISTANT. The NPI Number for NICOLE WOLF is 1104365014

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE WOLF
NPI
1104365014
Phone
Not provided
Address
500 OSBORN BLVD
Enumeration Date
13 February 2017
Last Update Date
24 April 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2016 (10 years ago)
PAC ID
8325324536
Group Practice PAC ID
8022150556
Professional Enrollment ID
I20170424000499
Address ID
MI497708344PE1890X3XXX600
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for NICOLE WOLF

  • War Memorial Hospital, 500, Osborn Boulevard, Sault Ste. Marie, Chippewa County, Michigan, 49783, United States

    SAULT SAINTE MARIE, MI 497831822

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 29 Open Payments records for all available years, with a total value of $647.

Total Amount is formed as General ($647) + Research ($0) + Ownership ($0) = $647.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($189).

Total Amount

$647

General + Research + Ownership

Payments

29

Total payment records

General Amount

$647

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

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: 2020-04-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20170424000499IPhysician AssistantMITBD
I20200403002410IPhysician AssistantTNTBD

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 49783)

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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: 8022150556View full group profile
NameSpecialtyState
Physician AssistantMI
Family PracticeMI
Family PracticeMI

Reviews

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Frequently asked questions

What unique ID ties claims to NICOLE WOLF?
NPI 1104365014 is assigned to NICOLE WOLF under the national enumeration system.
Does this profile mean NICOLE WOLF is currently active?
Yes — NICOLE WOLF appears active in the national provider directory.
What does NICOLE WOLF treat or focus on?
Patients typically see NICOLE WOLF under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is NICOLE WOLF's primary listing?
We display Sault Sainte Marie, Michigan because that is what the record indicates for NICOLE WOLF.
What if Sault Sainte Marie, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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