Ian Walters, MD, MA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A197783 Issued in CA

Practice address

250 S G St
San Bernardino, CA 92410-3320

Phone

(909) 382-7100

NPI assigned

May 24, 2021

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

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sac Health SystemGroup PAC ID 4385533579, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iwalters373130@direct.llu.edu

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.

• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Transplant Surgery Physician
  • Palm Springs, CA
  • NPI 1952064222
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Rialto, CA
  • NPI 1386266112
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  Care Compare affiliation

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1689249427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson Street, GME Office Westerly Suite 'C'",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "IAN",
        "credential": "MD, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "TLL-2024-006",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A197783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mysheva Walls
• Walmart Inc.
• Walmart Pharmacy
• Eugene Walper
• Zarah Walter
• Nicholas Walther, PA-C
• Mary Virginia Walthers
• James Walton
• Hua Wang, M.D
• Luping Wang, LAC

• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.