Active NPI
David Scott Wakeling, D.O.
- Internal Medicine Physician
- Tualatin, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DO15848
- Practice address
- 19300 SW 65TH Ave
Tualatin, OR 97062-7706 - Phone
- (503) 692-2430
- NPI assigned
- Mar 29, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DO15848 | OR | Primary |
Addresses
Primary practice location
19300 SW 65TH Ave
Tualatin, OR 97062-7706
Mailing address
3912 SW Altadena Ave
Portland, OR 97239
Phone (503) 753-5493
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048160 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Chicago College of Medicine and Surgery, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212
Hospital & facility affiliations
- Legacy Meridian Park Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.62 of 100
- Quality
- 77.21
- Promoting interoperability
- 99.06
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15848 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Internal Medicine | Current | Accepting new patients |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients |
Locations
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
2800 N Vancouver Ave
Ste 201
Portland, OR 97227
Phone (503) 276-9000
1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074
342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660
19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Silverton, OR
- NPI 1669424354
-
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
-
- Multi-Specialty Clinic/Center
- Silverton, OR
- NPI 1215274360
-
- Clinic/Center
- Molalla, OR
- NPI 1861116055
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tualatin, OR
- NPI 1184647620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300838400000",
"number": "1770544900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3912 SW ALTADENA AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-753-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19300 SW 65TH AVE",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627706",
"telephone_number": "503-692-2430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKELING",
"first_name": "DAVID",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2011-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "DO15848",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "048160",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.