Individual provider Active NPI

Laura Waialae, PA

  • Physician Assistant
  • Wheeling, WV
National Provider Identifier
1760968713
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2199 Issued in WV
Practice address
10 Medical Park
Suite 101
Wheeling, WV 26003
Phone
(304) 243-3889
Fax
(304) 243-8802
NPI assigned
Jul 12, 2018
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2199 WV Primary
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU

Addresses

Primary practice location

10 Medical Park
Suite 101
Wheeling, WV 26003

Mailing address

10 Medical Park
Suite 101
Wheeling, WV 26003
Phone (304) 243-3889

Other identifiers 1

IdentifierTypeStateIssuer
0313358MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181207000815 WV Practitioner - Physician Assistant 6901140524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2199WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Apr 4, 2021 Accepting new patients
Wheeling Hospital Inc CurrentSince Sep 17, 2018 Accepting new patients
Wheeling Hospital Inc Past Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

10 Medical Park
Ste 101
Wheeling, WV 26003
Phone (304) 243-3134

10 Medical Park
Ste 104
Wheeling, WV 26003
Phone (304) 242-4800

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1760968713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "SUITE 101",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3889",
            "fax_number": "304-243-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "SUITE 101",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3889",
            "fax_number": "304-243-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIALAE",
        "first_name": "LAURA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2199",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0313358",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.