Raed A Wahab, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

C161771 Issued in CA

Practice address

600 Coffee Rd
Modesto, CA 95355-4201

Phone

(209) 569-7408

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Critical Care (Intensivists)Also: Pulmonary Disease

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin Luther King Jr Community Medical FoundationGroup PAC ID 8628359502, 193 clinicians

Superior Hospitalist Medical Group IncGroup PAC ID 1456650928, 75 clinicians

Critical Care Consultants of Burbank Inc.Group PAC ID 6709306152, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779
• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Critical Care Consultants of Burbank Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Burbank, CA
  • NPI 1174359061
  Medicare reassignment Care Compare group NPD
• Martin Luther King Jr Community Medical Foundation

  dba Martin Lurher King Jr. Community Medical Group

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1356899777

  Pulmonary Disease

  Medicare reassignment Care Compare group NPD
• Superior Hospitalist Medical Group Inc

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1780047712

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Compassionate Critical Care Group, Inc.

  • Pulmonary Disease Physician
  • Woodland Hills, CA
  • NPI 1295332633

  Critical Care Medicine

  Medicare reassignment NPD
• Inpatient Specialists of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1952792475
  Medicare reassignment NPD
• Martin Luther King Jr Community Medical Foundation

  • Radiology Clinic/Center
  • Los Angeles, CA
  • NPI 1346082294
  NPD

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

• Martin Luther King, Jr. - Los Angeles (MLK-la) Healthcare Corporation

  dba Martin Luther King, Jr. Community Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114367497
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1285841437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-569-7408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Yakima Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984055309",
            "country_code": "US",
            "telephone_number": "253-363-8700",
            "fax_number": "253-272-0419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHAB",
        "first_name": "RAED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60740424",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C161771",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD60740424",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD434123",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "69074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042827",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Wagner, M.D.
• Karin Wagner
• Leilani Lynn Wagner, FNP-BC
• Paul Brooks Wagner, C.C.P.
• Kristin Wagoner, RN
• Stacy Waite-Ocampo, BCBA
• Daniela Waite
• Cheyenne Marie Waldo, LVN
• Suzanne Waldorf
• Walgreen Co (Walgreens #06355)

• Pulmonary Disease Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.