Stacy Leigh Waneka MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STACY LEIGH WANEKA MD PC

Practice address

2475 Townsgate Rd Ste 200
Westlake Village, CA 91361-5995

Phone

(818) 338-2540

Fax

(818) 338-1498

NPI assigned

Jul 18, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Stacy Waneka, MDNPI 1871557546

Title

President

Phone

(310) 270-3800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Stacy L Waneka, MD

  • Family Medicine Physician
  • Westlake Village, CA
  • NPI 1871557546
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1811622624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 LAS VIRGENES RD APT 7",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913022693",
            "telephone_number": "310-270-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 TOWNSGATE RD STE 200",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913615995",
            "telephone_number": "818-338-2540",
            "fax_number": "818-338-1498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Rolling Oaks Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913611007",
            "country_code": "US",
            "telephone_number": "310-270-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STACY LEIGH WANEKA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "WANEKA",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-270-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sport Psychology by Carrie Hastings
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• Stacey'S Home Health Incorporated
• Frank Stainetti
• Stand Inbalance, LLC
• Stanley a. Organ, DDS, Inc.
• Star Gate Corp
• Jennifer Stark, D.O.

• Family Medicine Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.