Individual provider Active NPI

Gary Lee Waslewski, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Scottsdale, AZ
National Provider Identifier
1902890031
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
27254 Issued in AZ
Practice address
8630 E Via de Ventura Ste 201
Scottsdale, AZ 85258-3358
Phone
(480) 558-3744
Fax
(480) 558-3801
NPI assigned
Sep 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 27254 AZ Primary

Addresses

Primary practice location

8630 E Via de Ventura Ste 201
Scottsdale, AZ 85258-3358

Mailing address

8630 E Via de Ventura Ste 201
Scottsdale, AZ 85258-3358
Phone (480) 558-3744

Other identifiers 2

IdentifierTypeStateIssuer
490061MedicaidAZ
3Z3983OtherAZHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040623001299 AZ Practitioner - Orthopedic Surgery 8325023211 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Jun 27, 2019 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Jun 27, 2019 Accepting new patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery Past Accepting new patients
Gary Waslewski MD PC Sports Medicine PastSince Sep 15, 2004 Accepting new patients

Locations

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

3130 E Baseline Rd
Ste 101
Mesa, AZ 85204
Phone (480) 483-3937

1840 S Stapley Dr
Ste 137
Mesa, AZ 85204
Phone (602) 952-0002

26900 N Lake Pleasant Pkwy
Ste 210
Peoria, AZ 85383
Phone (623) 561-3000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

8630 E Via de Ventura
Ste 201
Scottsdale, AZ 85258
Phone (214) 556-3227

Interoperability endpoints

  • Direct secure messaging: gary.waslewski.1@600.direct.athenahealth.com
  • Direct secure messaging: gary.waslewski.1@16026.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1902890031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 E VIA DE VENTURA STE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583358",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8630 E VIA DE VENTURA STE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583358",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASLEWSKI",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-05",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "27254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490061",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.