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DONALD WOLFRAM M.D.
NPI 1669499257
Family Medicine in La Porte, IN

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1007 LINCOLNWAY, LA PORTE, IN 46350(219) 326-1234 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Donald Wolfram M.d. NPPES

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

DONALD WOLFRAM M.D. (NPI 1669499257) is an individual family medicine provider in La Porte, Indiana, licensed in Michigan (4301082038) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1669499257
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDONALD WOLFRAMCredential: M.D.
Location Address1007 LINCOLNWAYLa Porte, IN 46350-3201
Mailing Address9625 Red Arrow HwyBridgman, MI 49106-9559 · (269) 465-6050 · Fax (269) 465-3134
Phone(219) 326-1234
Sole ProprietorNo
Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 1992
Enumeration DateJuly 17, 2006
Last NPPES UpdateMarch 17, 2018
✔ NPI 1669499257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301082038
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 01041640A (IN), 4301082038 (MI)
1007 LINCOLNWAY, La Porte, IN 46350
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11007 LincolnwayLA Porte, IN 46350-3201 · Phone (219) 326-1234
Location 25515 Cleveland Ave Ste 5Stevensville, MI 49127-9670 · Phone (269) 429-9644 · Fax (269) 429-4002

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource.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

Donald Wolfram M.d. 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 ID7113020009
PECOS Enrollment IDI20070314000177
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.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
117 services117 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
88 services74 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
73 services71 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
72 services55 patients
Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347
An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.
53 services33 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
52 services48 patients

Hospital Affiliations CMS Care Compare 4

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

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150012
Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County
Emergency services Birthing friendly

Union Hospital Inc

Acute Care Hospitals · Terre Haute, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150023
Location1606 N Seventh StTerre Haute, IN 47804 · Vigo County
Emergency services Birthing friendly

Community Hospital Of Bremen Inc

Critical Access Hospitals · Bremen, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151300
Location1020 High RdBremen, IN 46506 · Marshall County
Emergency services

Margaret Mary Community Hospital Inc

Critical Access Hospitals · Batesville, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number151329
Location321 Mitchell AveBatesville, IN 47006 · Franklin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46350 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.54
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims1,100 services$0.37 avg. paid by Medicare
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252
DME-Medical/Surgical Supplies · category DA023N
2 suppliers18 claims570 services$3.13 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
2 suppliers17 claims1,895 services$0.37 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers22 claims22 services$20.72 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 20

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

STEPHANIE HILLYER RD
Dietitian, Registered
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-1234
SONALI SHUKLA MD
Pathology (Anatomic Pathology)
1007 LINCOLNWAY
LAPORTE, IN 46350
Laporte County (219) 326-2403
JOSEPH LEE NEWBERG MD
Emergency Medicine
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-1234
SMARI THORDARSON MD
Radiology (Diagnostic Radiology)
1007 LINCOLNWAY
LAPORTE, IN 46350
Laporte County (219) 326-2305
KRISHNA R PILLAI MD
Radiology (Diagnostic Radiology)
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-2305
STEPHANIE DAUBE PT
Physical Therapist
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-2621
PATHOLOGY ASSOCIATES OF NORTHWEST INDIANA INC
Pathology (Anatomic Pathology & Clinical Pathology)
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-2307
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
General Acute Care Hospital
1007 LINCOLNWAY
LA PORTE, IN 46350
Laporte County (219) 326-2494

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donald Wolfram's NPI number?

The NPI number for Donald Wolfram is 1669499257. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Donald Wolfram located?

Donald Wolfram practices at 1007 Lincolnway, La Porte, IN 46350. The listed phone number is (219) 326-1234.

What is Donald Wolfram's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Donald Wolfram enrolled in Medicare?

Yes. Donald Wolfram is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Donald Wolfram accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and CareSource list Donald Wolfram as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Donald Wolfram affiliated with any hospitals?

According to CMS data, Donald Wolfram is affiliated with Saint Joseph Regional Medical Center, Union Hospital Inc, Community Hospital Of Bremen Inc and Margaret Mary Community Hospital Inc.

When was this NPI record last updated?

The NPPES record for Donald Wolfram was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.