Ajay K Wakhloo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

223710 Issued in MA

Practice address

55 Lake Ave N
Department of Radiology
Worcester, MA 01655-0002

Phone

(508) 334-2776

NPI assigned

Jun 24, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1174559892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "address_2": "TURNPIKE STATION",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015450062",
            "telephone_number": "508-334-8815",
            "fax_number": "508-334-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKHLOO",
        "first_name": "AJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "223710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103761",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorcas Wairimu
• Douglas C Waite, MD
• Diane M. Waitkevich, NP
• Steve Ngoy Kimba Wakadilo, BSN RN
• Luke Arakel Wakeen
• Alex F Wakshinsky, M.D.
• Wal-Mart Stores East LP
• Coridalia Wald Chen, MD
• Nicole Walden, PSY.D.
• Jacob Barrett Waldman, APRN, AGACNP-BC

• Diagnostic Radiology Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.