Wayne Stuart Gradman, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G17696 Issued in CA

Practice address

235 S McCarty Dr
Beverly Hills, CA 90212-3701

Phone

(424) 653-8560

Fax

(310) 277-5045

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Triangle Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
  • NPI 1619041050
  NPD (past) Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1104934199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S MCCARTY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123701",
            "telephone_number": "424-653-8560",
            "fax_number": "310-277-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S MCCARTY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123701",
            "telephone_number": "424-653-8560",
            "fax_number": "310-277-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADMAN",
        "first_name": "WAYNE",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G17696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "00G176960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PERFORMING PROV",
            "identifier": "WG17696D",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gozde Gokozan, LMFT, LPCC, Marriage, Family and Child Professional Cou
• Jason Graber, M. D.
• Karen Nicole Graber, LMFT
• Grace Lee Peng, MD
• Grace Surgical
• Frederick Grady, MD
• George Graf, MD
• Ellen Smith Graff, PHD
• Jeffrey Gramer, M.D.
• Grant Williams MD, a Professional Corp

• Vascular Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.