Wendy Waks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA066090 Issued in PA

Practice address

19052 Marquesa Dr
Fort Myers, FL 33913-7898

Phone

(239) 464-8182

NPI assigned

Oct 1, 2024

Last updated

Oct 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 PA, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Philadelphia College of Osteopathic Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bobby Buka, M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1134349954
  Medicare reassignment Care Compare group
• Derm Specs of PA PLLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528823507
  Medicare reassignment

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1609694280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19052 MARQUESA DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339137898",
            "telephone_number": "239-464-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19052 MARQUESA DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339137898",
            "telephone_number": "239-464-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKS",
        "first_name": "WENDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA007043",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Carr Kimberling Wahler, PA-C
• Vanessa Waich
• Samantha Waite, COTA
• Deborah Waites, BA
• Rick Waks, D.O.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5034)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5321)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0987)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-5347)
• Wal-Mart Stores East, LP (Vision Center 30-5034)

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.