Individual provider Active NPI

Devdas Wali, M.D.

  • Plastic Surgery Physician
  • Pomona, CA
National Provider Identifier
1811909732
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A78108 Issued in CA
Practice address
155 W Willow St
Pomona, CA 91768-1829
Phone
(909) 865-2626
Fax
(909) 865-2010
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A78108 CA Primary

Addresses

Primary practice location

155 W Willow St
Pomona, CA 91768-1829

Mailing address

350 Vinton Ave
102
Pomona, CA 91767-3000
Phone (909) 865-0400

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000753 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General SurgeryPractitioner - Hand Surgery 6901835701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (909) 596-7733

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Usc Surgeons, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1811909732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 VINTON AVE",
            "address_2": "102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673000",
            "telephone_number": "909-865-0400",
            "fax_number": "909-865-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W WILLOW ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681829",
            "telephone_number": "909-865-2626",
            "fax_number": "909-865-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALI",
        "first_name": "DEVDAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A78108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.