MARCUS WOLLAK
NPI 1417572827
Physician Assistant in South Haven, MI

Q: What is Marcus Wollak's NPI number?

The NPI number for Marcus Wollak is 1417572827. It was assigned to this individual provider in the NPPES registry on June 11, 2020.

Q: What is Marcus Wollak's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Marcus Wollak was last updated on October 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 11, 2020PECOS EnrolledAccepts Medicare Assignment

930 BLUE STAR HWY, SOUTH HAVEN, MI 49090(269) 637-1115 Get Directions Write a Review

NPPES record last updated: October 27, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Marcus Wollak NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCUS WOLLAK (NPI 1417572827) is an individual physician assistant in South Haven, Michigan, licensed in Michigan (5601010639) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and maintains a secondary practice location in Eau Claire.

NPPES Registry Identity

NPI1417572827

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMARCUS WOLLAK

Location Address930 BLUE STAR HWYSouth Haven, MI 49090-7758

Mailing Address4015 Damon CtEau Claire, WI 54701-3035

Phone(269) 637-1115

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 11, 2020

Last NPPES UpdateOctober 27, 2021

NPPES CertifiedJune 24, 2021

✔ NPI 1417572827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MI · 5601010639

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

930 BLUE STAR HWY, South Haven, MI 49090

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Secondary Practice Location 1

Location 14015 Damon CtEau Claire, WI 54701-3035 · Phone (715) 225-2377

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marcus Wollak is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284036351

PECOS Enrollment IDI20210712003192

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230017

Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County

Emergency services Birthing friendly

Bronson South Haven Hospital

Acute Care Hospitals · South Haven, MI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number230085

Location955 S Bailey AveSouth Haven, MI 49090 · Van Buren County

Emergency services

Bronson Lakeview Hospital

Critical Access Hospitals · Paw Paw, MI

OwnershipVoluntary non-profit - Private

CMS Certification Number231332

Location408 Hazen StreetPaw Paw, MI 49079 · Van Buren County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49090 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers16 claims2,580 services$0.10 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers11 claims11 services$184.44 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

3 suppliers17 claims17 services$26.03 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RHONDA JO GOLA FNP

Nurse Practitioner (Family)