Individual provider Active NPI

Carter Elliott Wahl, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
National Provider Identifier
1467615070
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A85194 Issued in CA
Practice address
300 Fir St
San Diego, CA 92101-2327
Phone
(619) 446-1646
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X A85194 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A85194 CA Primary

Addresses

Primary practice location

300 Fir St
San Diego, CA 92101-2327

Mailing address

300 Fir St
San Diego, CA 92101-2327
Phone (619) 446-1646

Other identifiers 1

IdentifierTypeStateIssuer
A85194MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080916000574 CA Practitioner - Pathology 5294802377 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 17, 2012 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 17, 2012 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

Interoperability endpoints

  • Direct secure messaging: cwahl19930@sharphealthcare.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1467615070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FIR ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012327",
            "telephone_number": "619-446-1646",
            "fax_number": "858-636-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FIR ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012327",
            "telephone_number": "619-446-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "CARTER",
        "middle_name": "ELLIOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A85194",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A85194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A85194",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.