Individual provider Active NPI

Scott J Wada, M.D.

  • Obstetrics & Gynecology Physician
  • Monterey, CA
National Provider Identifier
1831119403
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G54251 Issued in CA
Practice address
23845 Holman Hwy Ste 227
Monterey, CA 93940-5901
Phone
(831) 620-0700
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G54251 CA Primary

Addresses

Primary practice location

23845 Holman Hwy Ste 227
Monterey, CA 93940-5901

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

Other identifiers 1

IdentifierTypeStateIssuer
00G542510MedicaidCA

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
I20040520000932 CA Practitioner - Obstetrics/Gynecology 4789675596 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G54251CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Nov 1, 2023 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Jan 1, 2023 Accepting new patients
Montage Medical Group CurrentSince Feb 1, 2023 Accepting new patients
Sutter East Bay Medical Foundation Obstetrics & Gynecology Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

23845 Holman Hwy
Ste 227
Monterey, CA 93940
Phone (831) 582-2100

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

1555 Soquel Dr
Santa Cruz, CA 95065
Phone (831) 462-7700

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1831119403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23845 HOLMAN HWY STE 227",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405901",
            "telephone_number": "831-620-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "SCOTT",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G54251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G542510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.