Robert E Wailes MD a Professional

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ROBERT E WAILES MD A PROFESSIONAL

Practice address

3998 Vista Way Ste C106
Oceanside, CA 92056-4500

Phone

(760) 941-2600

Fax

(760) 941-4814

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Robert Eugene Wailes, M.D.NPI 1154362630

Title

Ceo

Phone

(760) 753-1104

Specialties & licenses 1

Addresses

Other names 1

• Pacific Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Pacific Surgery CenterCCN 05C0001203

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon O Dairo, M.D.

  • Interventional Pain Medicine Physician
  • San Diego, CA
  • NPI 1689092470
  Medicare reassignment NPD
• Nathan Adam Perrizo, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Oceanside, CA
  • NPI 1043309529
  Medicare reassignment NPD
• Brooke Towne, M.D.

  • Interventional Pain Medicine Physician
  • Oceanside, CA
  • NPI 1225532039
  Medicare reassignment NPD
• Robert Eugene Wailes, M.D.

  • Specialist
  • Oceanside, CA
  • NPI 1154362630
  NPD Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1699863258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N. EL CAMINO REAL STE B301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-753-1104",
            "fax_number": "760-943-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY STE C106",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564500",
            "telephone_number": "760-941-2600",
            "fax_number": "760-941-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E WAILES MD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "WAILES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-753-1104",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin Roach
• Jennifer Leanne Robbins
• Tricia Roberge
• Robert a Ring
• Robert B Pendleton MD PHD Inc
• Robert J. Stanford, DDS, MPH, Apc
• Emma Robert
• Audrey Zanzucchi Roberts, PA-C
• Bart Roberts
• Kendall L Roberts

• Ambulatory Surgical Clinic/Center in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.