BRENT STEVEN WALLER FNP-BC
NPI 1356973432
Nurse Practitioner - Family in Anaheim, CA
About Brent Steven Waller Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRENT STEVEN WALLER FNP-BC (NPI 1356973432) is an individual family provider in Anaheim, California, licensed in California (95013038) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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
Brent Steven Waller Fnp-bc 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 Brent Waller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Anaheim, CA 92804
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Anooshiravan Hami MD Corp
- 4 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.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ANAHEIM, CA 92804
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 Brent Waller's NPI number?
The NPI number for Brent Waller is 1356973432. It was assigned to this individual provider in the NPPES registry on February 6, 2020.
Where is Brent Waller located?
Brent Waller practices at 3400 W Ball Rd Ste 207, Anaheim, CA 92804. The listed phone number is (714) 683-5100.
What is Brent Waller's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Brent Waller enrolled in Medicare?
Yes. Brent Waller 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 Brent Waller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brent Waller reassigns Medicare benefits to Anooshiravan Hami, M.D., Corp (Anaheim, 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 Brent Waller'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 Brent Waller was last updated on February 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Brent Steven Waller, FNP-BC · NPI 1356973432
Family physician in Anaheim, California. Individual provider, active in the CMS NPPES registry since February 6, 2020.
## Identity
- **NPI:** 1356973432 (Entity type: Individual)
- **Enumerated:** February 6, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95013038 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3400 W BALL RD STE 207, Anaheim, CA 92804-3737
- **Phone:** (714) 683-5100
## 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:** Anooshiravan Hami, M.D., Corp (NPI 1710382189, Anaheim, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** February 7, 2020
- **Other identifiers:** Other 95013038 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1356973432) · Data from the CMS NPPES public registry.