Alexander D. Wielaard, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0071128 Issued in MD

Practice address

340 S Lemon Ave
9926
Walnut, CA 91789-2706

Phone

(706) 306-4668

NPI assigned

May 17, 2007

Last updated

Nov 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GU

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Guam Healthcare Development Incorporated

  dba Guam Regional Medical City

  • General Acute Care Hospital
  • Dededo, GU
  • NPI 1194159525

  Corporate Director, Corporate Officer, Operational/Managerial Control

  CMS ownership

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

• Guam Healthcare Development Incorporated

  dba GRMC Specialty Care Center

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment NPD Authorized official
• Guam Memorial Hospital

  • General Acute Care Hospital
  • Oka Tamuning, GU
  • NPI 1366519027
  Medicare reassignment NPD
• Guam Healthcare Development Incorporated

  dba Guam Regional Medical City

  • General Acute Care Hospital
  • Dededo, GU
  • NPI 1194159525
  NPD Authorized official
• Guam Memorial Hospital

  • Skilled Nursing Facility
  • Oka Tamuning, GU
  • NPI 1952479131
  NPD
• Denali Emergency Medicine Assoc PC

  • Emergency Medicine Physician
  • Anchorage, AK
  • NPI 1669406831
  NPD (past)
• Eastern Shore Emergency Medicine Physicians, LLC

  • Emergency Medicine Physician
  • Cambridge, MD
  • NPI 1558314203
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1144438995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE",
            "address_2": "9926",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706",
            "telephone_number": "706-306-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE",
            "address_2": "9926",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706",
            "telephone_number": "706-306-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAARD",
        "first_name": "ALEXANDER",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0071128",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "M-2007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Wang, DDS
• Tien Chun D. Wang, DDS
• Yiching Wang
• Yue Wang
• Chen Wen
• Isabel Elodia Wilhelm, PA-C
• Danielle Denise Williams
• Heather Williams, PMHNP
• Wisdom Wellness Psychotherapy Inc
• Amber Leanne Wong

• Emergency Medicine Physician in Walnut, CA
• Providers in Walnut, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.