Stephen David Wakulchik Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD034118E Issued in PA

Practice address

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010

Phone

(610) 325-1390

Fax

(610) 325-1373

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Athens Nutrition, LLC

  • Registered Dietitian
  • Ardmore, PA
  • NPI 1073963955
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1265482616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "19010",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083512",
            "country_code": "US",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAKULCHIK",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD034118E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleeza K Wachs, CNM
• Christine Wachter, MS, LPC
• Alexandra M Wack, CRNP
• Daniel S. Wagman, PAC
• Kristin Behrens Wagner, M.A.
• Jenna Walck
• Michael James Walker, MD
• Hilary P Waller, LPC
• Alexis Marie Walls, PA-C
• Kevin Michael Walsh, M.D.

• Family Medicine Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.