Active NPI
Waldo Concepcion, MD
- Surgery Physician
- Stanford, CA
National Provider Identifier
1770518870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A40271
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A40271 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3341
Phone (650) 723-4000
Other practice location 1
1500 E 2nd St Ste 300
Reno, NV 89502-1198
Phone (775) 982-5000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15435 | Other | NV | NEVADA STATE BOARD OF MEDICAL EXAMINERS |
| 11676755 | Other | NV | CAQH NUMBER |
| 00A402710 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070116000137 | CA | Practitioner - General Surgery | 9537160635 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A40271 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544745600000",
"number": "1770518870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 EMBARCADERO RD",
"address_2": "STE 100",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943033341",
"telephone_number": "650-723-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "1500 E 2nd St Ste 300",
"address_purpose": "LOCATION",
"city": "Reno",
"state": "NV",
"postal_code": "895021198",
"country_code": "US",
"telephone_number": "775-982-5000",
"fax_number": "775-982-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONCEPCION",
"first_name": "WALDO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2018-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A40271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEVADA STATE BOARD OF MEDICAL EXAMINERS",
"identifier": "15435",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH NUMBER",
"identifier": "11676755",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A402710",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.