Active NPI
Scott W Weatherwax, M.D.
- Anesthesiology Physician
- Irvine, CA
National Provider Identifier
1639267263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G58975
- Practice address
- 18952 Macarthur Blvd
# 103
Irvine, CA 92612-1432 - Phone
- (949) 833-1432
- Fax
- (949) 705-5455
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G58975 | CA | Primary |
Addresses
Primary practice location
18952 Macarthur Blvd
# 103
Irvine, CA 92612-1432
Mailing address
PO Box 2757
Orange, CA 92859-0757
Phone (714) 973-2650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G58975 | CA | MD | Anesthesiology Physician |
| 58975 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin J Dolan III M.D., Inc | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Irvine, CA
- NPI 1649343534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411689600000",
"number": "1639267263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2757",
"city": "ORANGE",
"state": "CA",
"postal_code": "928590757",
"telephone_number": "714-973-2650",
"fax_number": "714-973-2655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18952 MACARTHUR BLVD",
"address_2": "# 103",
"city": "IRVINE",
"state": "CA",
"postal_code": "926121432",
"telephone_number": "949-833-1432",
"fax_number": "949-705-5455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERWAX",
"first_name": "SCOTT",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2014-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G58975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.