NPIMap

Individual provider Active NPI

Wendy Eve Weiss, DO

  • Family Medicine Physician
  • Pismo Beach, CA
National Provider Identifier
1609867738
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6436 Issued in CA
Practice address
575 Price St
Suite 101
Pismo Beach, CA 93449-2553
Phone
(805) 773-0707
Fax
(805) 773-2051
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6436 CA Primary

Addresses

Primary practice location

575 Price St
Suite 101
Pismo Beach, CA 93449-2553

Mailing address

575 Price St
Suite 101
Pismo Beach, CA 93449-2553
Phone (805) 773-0707

Other identifiers 2

IdentifierTypeStateIssuer
00AX64360MedicaidCA
020A64360OtherCABLUE SHIELD PIN

Other names 1

  • Dr. Wendy Eve Dasilva Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000023 CA Practitioner - Family Practice 8123062999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

575 Price St
Suite 101
Pismo Beach, CA 93449-2553
Phone (805) 773-0707

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
35.22 of 100Reported as individual
Quality
34.95
Improvement activities
0
Cost
60.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6436CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1609867738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PRICE ST",
            "address_2": "SUITE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492553",
            "telephone_number": "805-773-0707",
            "fax_number": "805-773-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PRICE ST",
            "address_2": "SUITE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492553",
            "telephone_number": "805-773-0707",
            "fax_number": "805-773-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "WENDY",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX64360",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "020A64360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "DASILVA",
            "middle_name": "EVE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pismo Beach, CA

Sources for this page

Verify at the official NPI Registry.