Wallis Taylor Muhly, M.D.

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

License

MD439078 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-1858

Fax

(215) 590-1415

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children's Anesthesiology Associates, LTD

  dba CAA Anesthesiology Services

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1689779480
  Medicare reassignment NPD
• Children's Anesthesiology Associates, LTD

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1942213525
  NPD

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1114155991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "267-425-9300",
            "fax_number": "297-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Goddard Blvd",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062922",
            "country_code": "US",
            "telephone_number": "610-337-3232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUHLY",
        "first_name": "WALLIS",
        "middle_name": "TAYLOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD439078",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD439078",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025918190001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "221569EJL",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atalie Muhammad
• Muniyra Muhammad, NCC
• Najib Muhammad
• Tanaaz Muhayya
• James Muhly
• Eli Muhrer, MD
• Zakiyyah Muhsin-Fall
• Waliyyah Shahidah Muhsin, RN, CDE
• Mariko Mui, M.D.
• Victoria Mui, M.D.

• Pediatric Anesthesiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.