Individual provider Active NPI

Anne Kern Wakamiya, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Stanford, CA
National Provider Identifier
1063774610
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A126416 Issued in CA
Practice address
401 Quarry Road
Stanford, CA 94305
Phone
(650) 725-5591
NPI assigned
Jun 11, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A126416 CA Primary

Addresses

Primary practice location

401 Quarry Road
Stanford, CA 94305

Mailing address

10945 Le Conte Ave Dept of
Los Angeles, CA 90095-3000
Phone (415) 827-2971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129002746 CA Practitioner - Internal Medicine 3173828274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Practice addresses (Care Compare)

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

150 Pioneer LN
Bishop, CA 93514-2599

152 Pioneer LN
Bishop, CA 93514-2563

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A126416CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Inyo Healthcare District CurrentSince Jul 29, 2018 Accepting new patients
Northern Inyo Healthcare District Current Accepting new patients
Northern Inyo Healthcare District PastSince May 4, 2025 Accepting new patients

Locations

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

152 Pioneer Ln
Ste F
Bishop, CA 93514
Phone (760) 872-1606

153 Pioneer Ln
Ste B
Bishop, CA 93514
Phone (760) 873-2602

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063774610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 LE CONTE AVE DEPT OF",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953000",
            "telephone_number": "415-827-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY ROAD",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-725-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKAMIYA",
        "first_name": "ANNE",
        "middle_name": "KERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A126416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.