NPIMap

Individual provider Active NPI

Robert Brian Wade, MD

  • Specialist
  • Moundsville, WV
National Provider Identifier
1801882303
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19185 Issued in WV
Practice address
1001 3Rd St
Moundsville, WV 26041-1606
Phone
(304) 845-3464
Fax
(304) 845-2208
NPI assigned
Sep 21, 2005
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19185 WV Primary

Addresses

Primary practice location

1001 3Rd St
Moundsville, WV 26041-1606

Mailing address

3 Wood Duck MDW
Glen Dale, WV 26038-1234
Phone (304) 845-3464

Other identifiers 1

IdentifierTypeStateIssuer
0055148000MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rwade121935@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address rwade121935@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060814000102 WV Practitioner - Family PracticePractitioner - Hospitalist 7719980747 Reassigns benefits to 1 organization
Practice locations: Moundsville, WV

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
West Virginia University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 3Rd St
Moundsville, WV 26041-1655
Phone (304) 845-3464

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital Inc CurrentSince Nov 1, 2011 Accepting new patients
Floral Leasing Co., LLC Past Accepting new patients
Med Health Services Management, LP Specialist Past Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Moundsville Healthcare CenterMoundsville, WV, CCN 515067 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2022
Jul 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 4

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1801882303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOOD DUCK MDW",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381234",
            "telephone_number": "304-845-3464",
            "fax_number": "304-845-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 3RD ST",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411606",
            "telephone_number": "304-845-3464",
            "fax_number": "304-845-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ROBERT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "19185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055148000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwade121935@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 3rd St",
            "city": "Moundsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260411655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwade121935@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 3rd St",
            "city": "Moundsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260411655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moundsville, WV

Sources for this page

Verify at the official NPI Registry.