Samuel Isaac Wahl, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

2006-01411 Issued in NC

Practice address

30 Memorial Dr
Pinehurst, NC 28374-8707

Phone

(910) 295-4400

Fax

(910) 295-2810

NPI assigned

Aug 1, 2006

Last updated

Jun 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Diagnostic Radiology

Education

East Tennessee State University Quillen College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Vein Restoration NC PLLCGroup PAC ID 9638557622, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.wahlmd.p3@direct.cvr.nextgenshare.com

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.

• Center for Vein Restoration NC PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Greensboro, NC
  • NPI 1083363881
  Medicare reassignment Care Compare group NPD
• Carolina Vascular Center, PLLC

  • Surgery Physician
  • Durham, NC
  • NPI 1841627742
  Medicare reassignment NPD
• Center for Vein Restoration NC PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1013878024
  NPD
• Carolina Vein Specialists, P.a.

  • Vascular Surgery Physician
  • Greensboro, NC
  • NPI 1861528812
  NPD (past)
• Pinehurst Radiology Associates

  • Specialist
  • Pinehurst, NC
  • NPI 1073567244
  NPD (past)
• Pinehurst Radiology Group P a

  • Specialist
  • Pinehurst, NC
  • NPI 1861445686
  NPD (past)
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Diagnostic Radiology

  NPD (past)
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  NPD (past)
• Radiologic Associates Prof Corp

  • Diagnostic Radiology Physician
  • Middletown, NY
  • NPI 1033125844
  NPD (past)
• West Hudson Imaging Associates, PLLC

  • Diagnostic Radiology Physician
  • Newburgh, NY
  • NPI 1982610713
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1649286493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748707",
            "telephone_number": "910-295-4400",
            "fax_number": "910-295-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748707",
            "telephone_number": "910-295-4400",
            "fax_number": "910-295-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "SAMUEL",
        "middle_name": "ISAAC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2006-01411",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2006-01411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904644",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "14263",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Von Hardenberg, MD
• Anna Marie Vosberg, MSW, LCAS(R)
• Matthew John Vreeland, MD
• Eric Preston Waddington, M.D.
• Carol M Wadon, M.D.
• Julie M Walenta, DIETICIAN
• Walgreen Co (Walgreens #17067)
• James B. Walker, MD
• Latiea Walker
• Tja'Lyza Walker

• Vascular & Interventional Radiology Physician in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Vascular & Interventional Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.
• 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.