MICHAEL WAYNE WOLFE MD
NPI 1366415556
Orthopaedic Surgery in Jefferson, LA
NPI Status: Active since February 09, 2006
Contact Information
1514 JEFFERSON HIGHWAY
JEFFERSON, LA
ZIP 70121
Phone: (504) 703-7114
Fax: (504) 842-6784
- Individual
- Male
- Orthopaedic Surgery
- Accepts Insurance
- PECOS Enrolled
About MICHAEL WOLFE
This page provides the complete NPI Profile along with additional information for Michael Wolfe, a provider established in Jefferson, Louisiana with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1366415556 assigned on February 2006. The practitioner's primary taxonomy code is 207X00000X with license number 0101224713 (VA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1366415556
- Provider Name
- MICHAEL WAYNE WOLFE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1514 JEFFERSON HIGHWAY JEFFERSON, LA 70121
- Location Phone
- (504) 703-7114
- Location Fax
- (504) 842-6784
- Mailing Address
- 1514 JEFFERSON HIGHWAY JEFFERSON, LA 70121
- Mailing Phone
- (504) 703-7114
- Mailing Fax
- (504) 842-6784
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-09-2006
- Last Update Date
- 01-04-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 0101224713
- License State
- VA
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
- Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
- Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
- Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (H) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (L) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (N) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (S) - POS
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1366415556 | OTHER (01) | VA | AETNA |
| 1366415556 | OTHER (01) | VA | ANTHEM |
| 1366415556 | OTHER (01) | VA | HEALTHKEEPERS PLUS |
| 371194700 | OTHER (01) | VA | BLACK LUNG |
| 1366415556 | OTHER (01) | VA | VIRGINIA HEALTH NETWORK |
| 1366415556 | OTHER (01) | VA | HUMANA MEDICARE |
| 1366415556 | MEDICAID (05) | VA | |
| 540506332004 | OTHER (01) | VA | TRICARE/CHAMPUS |
| 1366415556 | OTHER (01) | VA | HEALTHKEEPERS |
| 1366415556 | OTHER (01) | VA | MEDICAID OF WEST VIRGINIA |
| 1366415556 | OTHER (01) | VA | CIGNA |
| 1366415556 | OTHER (01) | VA | GATEWAY |
| P00264565 | OTHER (01) | VA | RAILROAD MEDICARE |
| 1366415556 | OTHER (01) | VA | UNITED HEALTHCARE |
| 1366415556 | OTHER (01) | VA | OPTIMA HEALTH PLAN |
| 1366415556 | OTHER (01) | VA | UMWA |
| 1366415556 | OTHER (01) | VA | INTOTAL |
| 1366415556 | OTHER (01) | VA | SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY |
| 1366415556 | OTHER (01) | VA | VA PREMIER |
Medicare Participation & PECOS Enrollment Status
Michael Wolfe is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)
1 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Other DME (DE000N)
Commode chair, mobile or stationary, with fixed arms (HCPCS:E0163)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF000N)
Lower extremity orthoses, not otherwise specified (HCPCS:L2999)
1 DME suppliers used 11 Medicare Claims 14 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Hip replacement
Knee replacement
New patient office or other outpatient visit, 30-44 minutes
Replacement of knee joint, both sides of knee
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 44 times for 36 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 148 times for 122 patientsA hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.
This service was performed for 40 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 100 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 87 times for 87 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 22 times for 19 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 70121 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $86.76
- Minimum New Patient Price $55.5
- Maximum New Patient Price $170.3
- Average New Patient Copayment $21.69
- Minimum New Patient Copayment $13.87
- Maximum New Patient Copayment $42.57
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.44
- Minimum Established Patient Price $17.42
- Maximum Established Patient Price $138.03
- Average Established Patient Copayment $17.36
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $34.5
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366415556, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366415556, enumerated as an "individual" on February 09, 2006.
The provider is located at 1514 JEFFERSON HIGHWAY JEFFERSON, LA 70121 and the phone number is (504) 703-7114.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, HMO. Please consult your insurance carrier or call the provider to verify.
