ANDERS K WAALEN
NPI 1336776806
Student in an Organized Health Care Education/Training Program in Port Jefferson, NY
About Anders K Waalen NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDERS K WAALEN (NPI 1336776806) is an individual student in an organized health care education/training program in Port Jefferson, New York and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Anders K Waalen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Anders Waalen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92120
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Anders Waalen's NPI number?
The NPI number for Anders Waalen is 1336776806. It was assigned to this individual provider in the NPPES registry on March 25, 2020.
Where is Anders Waalen located?
Anders Waalen practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 686-2518.
What is Anders Waalen's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Anders Waalen enrolled in Medicare?
Yes. Anders Waalen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Anders Waalen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Anders Waalen reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anders Waalen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Anders Waalen was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Anders K Waalen · NPI 1336776806
Student in an Organized Health Care Education/Training Program provider in Port Jefferson, New York. Individual provider, active in the CMS NPPES registry since March 25, 2020.
## Identity
- **NPI:** 1336776806 (Entity type: Individual)
- **Enumerated:** March 25, 2020
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 75 N COUNTRY RD, Port Jefferson, NY 11777-2119
- **Phone:** (631) 686-2518
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1225060742, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** October 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1336776806) · Data from the CMS NPPES public registry.