Becky L Wallin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A55243 Issued in CA

Practice address

2400 Samaritan Dr
Suite 203
San Jose, CA 95124-3910

Phone

(408) 879-9941

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mrs. Becky L McCalla Other name

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

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

Chicago College of Medicine and Surgery, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Saratoga, CA, CCN 757662
• Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmdpamfwallin115295@hisp.ehr.sutterhealth.org

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

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538

  Family Medicine

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• El Camino Hospital

  • General Acute Care Hospital
  • Mountain View, CA
  • NPI 1093712374
  NPD (past)
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)
• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1437103777
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Saratoga, CA
  • NPI 1558029876
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093764078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SAMARITAN DR",
            "address_2": "SUITE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243910",
            "telephone_number": "408-879-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "BECKY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A55243",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00118398",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1002837",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BECKY",
            "last_name": "MCCALLA",
            "middle_name": "L",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aaron Wallace
• Dameon Wallace
• Shamika D Wallace, RN, BSN, CWC
• Tawni Wallace, AU.D.
• Tara-Ann Joy Waller, AU.D.
• Julie Mae Wallingford, M.ED., BCBA
• Lydia Anna Walls
• David Wallsom
• Walmart Inc.
• Walmart Inc.

• Family Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.