Mac Theodore Wayment, DO

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

20A9172 Issued in CA

Practice address

1700 Prairie City Rd
Folsom, CA 95630-9594

Phone

(916) 351-4800

Fax

(916) 351-4899

NPI assigned

May 4, 2007

Last updated

Nov 10, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• County of Ventura

  dba Ventura County Medical Center

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment NPD
• Pokroy Medical Group of Nevada, LTD.

  dba Pediatrix Medical Group of Nevada

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412
  Medicare reassignment
• County of Ventura

  dba VCBH - Simi Valley Youth & Family Mental Health

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD
• County of Ventura

  • Public Health & General Preventive Medicine Physician
  • Oxnard, CA
  • NPI 1801325303
  NPD
• Dignity Health

  dba St. Rose Dominican Hospital, Siena Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1609088350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PRAIRIE CITY RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309594",
            "telephone_number": "916-351-4800",
            "fax_number": "916-351-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hillmont Ave",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031651",
            "country_code": "US",
            "telephone_number": "805-652-6237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAYMENT",
        "first_name": "MAC",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A 9172",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "20A9172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mac.wayment@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christa Warner, LMFT
• Alexandria Washington
• Sally Brooke Watkins, L.C.S.W.
• Limor H Watson, PSY.D
• Jason Ryan Way, N.D.
• Dennis M Wazac, D.C.
• Aggie Weber
• Alison Castro Webster, LCSW
• Shawn Martin Wedworth, PHARM.D.
• Sarah Wegemer, PHARMD

• Pediatric Critical Care Medicine Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.