Individual provider Active NPI

Paul S Wahlheim, MD

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1114935442
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
28833 Issued in AZ
Practice address
305 W. Thomas Road
St. Joseph'S Hospital
Phoenix, AZ 85013
Phone
(602) 406-3000
Fax
(602) 406-7165
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 28833 AZ Primary

Addresses

Primary practice location

305 W. Thomas Road
St. Joseph'S Hospital
Phoenix, AZ 85013

Mailing address

1241 W Mineral Ave
Suite 100
Littleton, CO 80120-5685
Phone (303) 759-0854

Other identifiers 2

IdentifierTypeStateIssuer
616617MedicaidAZ
P00033434OtherAZRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040427000602 AZ Practitioner - Emergency Medicine 1759282957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower St Josephs PLLCGroup PAC ID 2961866173, 52 clinicians

Practice addresses (Care Compare)

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Hospital & facility affiliations

  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS010436LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Empower St Josephs PLLC Emergency Medicine CurrentSince Jan 24, 2024 Accepting new patients
St. Joseph'S Hospital and Medical Center PastSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services Past Accepting new patients
Mesa General Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients

Locations

7300 N 99th Ave
Glendale, AZ 85307
Phone (480) 339-5001

17040 N 51st Ave
Ste 100
Glendale, AZ 85308
Phone (602) 406-1164

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

14818 N 74th St
Scottsdale, AZ 85260
Phone (480) 339-5088

Organizations & group practices 5

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 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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1114935442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W MINERAL AVE",
            "address_2": "SUITE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205685",
            "telephone_number": "303-759-0854",
            "fax_number": "303-759-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W. THOMAS ROAD",
            "address_2": "ST. JOSEPH'S HOSPITAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-3000",
            "fax_number": "602-406-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLHEIM",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "28833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616617",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00033434",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.