Individual provider Active NPI

John L Wade, MD

  • Diagnostic Radiology Physician
  • Hilo, HI
National Provider Identifier
1326087487
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD20349 Issued in HI
Practice address
688 Kinoole St Ste 103
Hilo, HI 96720-3868
Phone
(808) 969-8010
Fax
(903) 663-7394
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME78473 FL
Diagnostic Radiology Physician 2085R0202X FF0532689 VT
Diagnostic Radiology Physician 2085R0202X MD20349 HI Primary

Addresses

Primary practice location

688 Kinoole St Ste 103
Hilo, HI 96720-3868

Mailing address

100 Hospital Dr
Bennington, VT 05201-5004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220329002411 AZ Practitioner - Diagnostic Radiology 4385607373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians
Southwest Diagnostic Imaging LLCGroup PAC ID 7416946199, 121 clinicians

Practice addresses (Care Compare)

1515 E Bethany Home Rd
Phoenix, AZ 85014-2495
Phone (832) 915-2534

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (832) 915-2534

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (832) 915-2534

6750 E Baywood Ave
Mesa, AZ 85206-1749
Phone (832) 915-2534

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (832) 915-2534

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4109
Phone (832) 915-2534

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (832) 915-2534

9220 E Mountain View Rd
Suite 100
Scottsdale, AZ 85258-5134
Phone (480) 425-5000

Hospital & facility affiliations

  • Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
  • Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087
  • Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092
  • Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014
  • Honorhealth Scottsdale Thompson Peak Med Ctr Hospital, Scottsdale, AZ, CCN 030123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME78473FLMDDiagnostic Radiology Physician
MD20349HIMDDiagnostic Radiology Physician
FF0532689VTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging of Colorado Radiology Imaging Assc PC Etal PT Diagnostic Radiology CurrentSince Jun 1, 2019 Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Radiology Imaging of Nebraska, LLC Diagnostic Radiology Past Accepting new patients

Locations (25 of 32)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

2323 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 931-7999

1515 E Bethany Home Rd
Phoenix, AZ 85014
Phone (602) 812-3080

9220 E Mountain View Rd
Ste 100
Scottsdale, AZ 85258

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255
Phone (480) 324-7000

3501 N Scottsdale Rd
Ste 130
Scottsdale, AZ 85251

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

5316 E Shea Blvd
Ste 150
Scottsdale, AZ 85254
Phone (480) 534-4530

16575 W Waddell Rd
Surprise, AZ 85388
Phone (623) 300-9110

1625 N Campbell Ave
Tucson, AZ 85719

10800 E Geddes Ave
Ste 300
Englewood, CO 80112
Phone (303) 791-9190

2001 70th Ave
Ste 100
Greeley, CO 80634
Phone (970) 352-8487

Organizations & group practices 4

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 5

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1326087487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 KINOOLE ST STE 103",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203868",
            "telephone_number": "808-969-8010",
            "fax_number": "903-663-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME78473",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VT",
            "license": "FF0532689",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD20349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.