ROBERT EUGENE WAILES M.D.
NPI 1154362630
Specialist in Oceanside, CA
NPI Status: Active since June 08, 2006
Contact Information
3998 VISTA WAY # C-108
OCEANSIDE, CA
ZIP 92056
Phone: (760) 753-1104
Fax: (760) 943-6494
- Individual
- Male
- Specialist
- PECOS Enrolled
- CLIA Number: 05D0930056
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-31-2026
About ROBERT WAILES
This page provides the complete NPI Profile along with additional information for Robert Wailes, a provider established in Oceanside, California with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1154362630 assigned on June 2006. The practitioner's primary taxonomy code is 174400000X with license number G47938 (CA). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1154362630
- Provider Name
- ROBERT EUGENE WAILES M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3998 VISTA WAY # C-108 OCEANSIDE, CA 92056
- Location Phone
- (760) 753-1104
- Location Fax
- (760) 943-6494
- Mailing Address
- 477 N. EL CAMINO REAL STE B301 ENCINITAS, CA 92024
- Mailing Phone
- (760) 753-1104
- Mailing Fax
- (760) 943-6494
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-08-2006
- Last Update Date
- 09-20-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- G47938
- License State
- CA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| WG47938C | MEDICARE PIN (08) | CA | |
| A50870 | MEDICARE UPIN (02) | CA |
Medicare Participation & PECOS Enrollment Status
Robert Wailes is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0930056
- Facility Type
- Physician Office
- Certificate Effective Date
- November 04, 2023
- Certificate Expiration Date
- May 31, 2026
- Laboratory Director
- JULIE A. GLADSJO MD
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Robert Wailes after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154362630, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154362630, enumerated as an "individual" on June 08, 2006.
The provider is located at 3998 VISTA WAY # C-108 OCEANSIDE, CA 92056 and the phone number is (760) 753-1104.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
