Individual provider Active NPI

Nathan Joseph Waxer, DO

  • Anesthesiology Physician
  • Ventura, CA
National Provider Identifier
1104137769
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A12107 Issued in CA
Practice address
147 N Brent St
Ventura, CA 93003-2809
Phone
(805) 652-5011
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A12107 CA Primary
Pediatric Anesthesiology Physician 207LP3000X 20A12107 CA

Addresses

Primary practice location

147 N Brent St
Ventura, CA 93003-2809

Mailing address

294 Walnut Dr
Ventura, CA 93003-2035
Phone (310) 806-1423

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
I20160106000495 CA Practitioner - Anesthesiology 2062714116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ventura Anesthesia Medical GroupGroup PAC ID 0648260836, 33 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49.94 of 100Reported as group
Quality
38.91
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12107CAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura Anesthesia Medical Group Anesthesiology CurrentSince Nov 7, 2015 Accepting new patients

Locations

3116 W March Ln
Ste 200
Stockton, CA 95219
Phone (510) 537-1234

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1104137769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 WALNUT DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032035",
            "telephone_number": "310-806-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXER",
        "first_name": "NATHAN",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A12107",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "20A12107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.