Active NPI
Walter R Pyka, M.D.
- Specialist
- San Mateo, CA
National Provider Identifier
1871509372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G46127
- Practice address
- 101 S San Mateo Dr
Ste#104
San Mateo, CA 94401-3819 - Phone
- (650) 558-9740
- Fax
- (650) 558-9790
- NPI assigned
- Aug 1, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | G46127 | CA | Primary |
Addresses
Primary practice location
101 S San Mateo Dr
Ste#104
San Mateo, CA 94401-3819
Mailing address
101 S San Mateo Dr
Ste#104
San Mateo, CA 94401-3819
Phone (650) 558-9740
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080616000809 | CA | Practitioner - Orthopedic Surgery | 3173694304 | Practice locations: San Mateo, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G46127 | CA | MD | Specialist |
Interoperability endpoints
- wpyka46059@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1871509372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S SAN MATEO DR",
"address_2": "STE#104",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013819",
"telephone_number": "650-558-9740",
"fax_number": "650-558-9790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S SAN MATEO DR",
"address_2": "STE#104",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013819",
"telephone_number": "650-558-9740",
"fax_number": "650-558-9790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PYKA",
"first_name": "WALTER",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G46127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.