Individual provider Active NPI

Michael J Wahl, MD

  • Family Medicine Physician
  • Butler, PA
National Provider Identifier
1265423404
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD056807L Issued in PA
Practice address
109 Technology Drive
Suite a
Butler, PA 16001-1785
Phone
(724) 431-0300
Fax
(724) 431-0301
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD056807L PA Primary

Addresses

Primary practice location

109 Technology Drive
Suite a
Butler, PA 16001-1785

Mailing address

109 Technology Drive
Suite a
Butler, PA 16001-1785
Phone (724) 431-0300

Other identifiers 1

IdentifierTypeStateIssuer
0018414400004MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060105000492 PA Practitioner - Family Practice 2466475413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Geriatric Care Services, Inc.Group PAC ID 0547232126, 35 clinicians

Practice addresses (Care Compare)

109 Technology Dr
Butler, PA 16001-1785
Phone (724) 482-0159

109 Technology Dr a
Butler, PA 16001-1785

1323 Freedom Rd
Cranberry Township, PA 16066-5001

Hospital & facility affiliations

  • Concordia Visiting Nurses Home health agency, Cabot, PA, CCN 397717
  • Independence Health System Butler Memorial Hospita Hospital, Butler, PA, CCN 390168
  • Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wahl Family Practice PC Family Medicine CurrentSince Nov 28, 2005 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

109 Technology Dr
Ste A
Butler, PA 16001
Phone (724) 431-0300

Organizations & group practices 3

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 6

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1265423404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 TECHNOLOGY DRIVE",
            "address_2": "SUITE A",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011785",
            "telephone_number": "724-431-0300",
            "fax_number": "724-431-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 TECHNOLOGY DRIVE",
            "address_2": "SUITE A",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011785",
            "telephone_number": "724-431-0300",
            "fax_number": "724-431-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD056807L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018414400004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.