Individual provider Active NPI

Duane Emil McWaine, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1629112123
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G056319 Issued in CA
Practice address
1314 Westwood Blvd
Suite 101D
Los Angeles, CA 90024-4902
Phone
(310) 474-5055
NPI assigned
Feb 16, 2007
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G056319 CA Primary

Addresses

Primary practice location

1314 Westwood Blvd
Suite 101D
Los Angeles, CA 90024-4902

Mailing address

800 S Victoria Ave, L4615
Vchca - Physician Services
Ventura, CA 93009-0003
Phone (805) 677-5181

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
I20140621000005 CA Practitioner - Psychiatry 2163646712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ButteGroup PAC ID 3779489356, 29 clinicians

Practice addresses (Care Compare)

560 Cohasset Rd
Suite 175
Chico, CA 95926-2460
Phone (530) 891-2784

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G056319CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Butte CurrentSince Feb 4, 2020 Accepting new patients
Traditions Psychiatry Group, P.C Psychiatry CurrentSince Feb 8, 2019 Accepting new patients
County of Butte CurrentSince Feb 4, 2020 Accepting new patients
County of Butte Current Accepting new patients

Locations

560 Cohasset Rd
Ste 175
Chico, CA 95926
Phone (530) 552-5076

3217 Cohasset Rd
Cohasset, CA 95973
Phone (530) 552-4578

995 Spruce St
Gridley, CA 95948
Phone (530) 846-7305

1580 1st St
Napa, CA 94559
Phone (707) 200-8225

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1629112123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S VICTORIA AVE, L4615",
            "address_2": "VCHCA - PHYSICIAN SERVICES",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930090003",
            "telephone_number": "805-677-5181",
            "fax_number": "805-677-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 WESTWOOD BLVD",
            "address_2": "SUITE 101D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244902",
            "telephone_number": "310-474-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWAINE",
        "first_name": "DUANE",
        "middle_name": "EMIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G056319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.