Wesley San, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

MD60632796 Issued in WA

Practice address

3315 S 23Rd St
Suite 200
Tacoma, WA 98405-1605

Phone

(253) 272-9994

Fax

(253) 572-0468

NPI assigned

May 2, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Physical Medicine and Rehabilitation

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Electrodiagnosis and Rehabilitation Associates of Tacoma PSGroup PAC ID 5597652677, 10 clinicians

Practice addresses (Care Compare)

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.

• Electrodiagnosis & Rehabilitation Associates of Tacoma, PS

  • Specialist
  • Tacoma, WA
  • NPI 1508821422
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1376834838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 S 23RD ST",
            "address_2": "SUITE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051605",
            "telephone_number": "253-272-9994",
            "fax_number": "253-572-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 S 23RD ST",
            "address_2": "SUITE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051605",
            "telephone_number": "253-272-9994",
            "fax_number": "253-572-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN",
        "first_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "MD60632796",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD60632796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Loren Sampson, MS, SUDT, MHP
• Jennifer Maria Sampson, PH.D., LMFT
• Michael Todd Sams, MPT, OCS
• Kelsey Monroe Samuelson, RN
• Shaelene San Nicolas-Cruz
• Fred F Sanaei, RPH
• Libeth Sanchez de la Cruz
• Ana Caren Sanchez Vidales, DSHS INTERPRETER
• Dana Michelle Sanchez-Terry, ARNP, FNP
• Gabrielle Sanchez

• Interventional Pain Medicine Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Interventional Pain Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.