DR. NATALISSE WAHLSTROM-DAVILA MD
NPI 1366145591
General Practice in Buckeye, AZ
About Dr. Natalisse Wahlstrom-davila Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. NATALISSE WAHLSTROM-DAVILA MD (NPI 1366145591) is an individual general practice provider in Buckeye, Arizona, licensed in Arizona (74447) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Guaynabo, and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
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
Dr. Natalisse Wahlstrom-davila Md 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 Reassignments
2Medicare enrollment records show Natalisse Wahlstrom-davila reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Buckeye, AZ 85326
- Reassigned Medicare billing, Arizona enrollment
- 12 clinicians in this Medicare group
Litchfield Park, AZ 85340
- Reassigned Medicare billing, Arizona enrollment
- 6 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 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BUCKEYE, AZ 85326
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 Natalisse Wahlstrom-davila's NPI number?
The NPI number for Natalisse Wahlstrom-davila is 1366145591. It was assigned to this individual provider in the NPPES registry on March 27, 2023.
Where is Natalisse Wahlstrom-davila located?
Natalisse Wahlstrom-davila practices at 1500 S Watson Rd Ste C104, Buckeye, AZ 85326. The listed phone number is (623) 025-1755.
What is Natalisse Wahlstrom-davila's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Natalisse Wahlstrom-davila enrolled in Medicare?
Yes. Natalisse Wahlstrom-davila 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 organizations bill Medicare for Natalisse Wahlstrom-davila's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Natalisse Wahlstrom-davila reassigns Medicare benefits to 2 organizations: Khakwani And Mohammad Medical PC (Buckeye, AZ) and Vein Envy LLC (Litchfield Park, AZ). Each 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 Natalisse Wahlstrom-davila's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Natalisse Wahlstrom-davila accept?
Health plans from Blue Cross Blue Shield of Arizona and UnitedHealthcare list Natalisse Wahlstrom-davila as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Natalisse Wahlstrom-davila was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. Natalisse Wahlstrom-Davila, MD · NPI 1366145591
General Practice physician in Buckeye, Arizona. Individual provider, active in the CMS NPPES registry since March 27, 2023.
## Identity
- **NPI:** 1366145591 (Entity type: Individual)
- **Enumerated:** March 27, 2023
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 74447 (Arizona)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1500 S WATSON RD STE C104, Buckeye, AZ 85326-8689
- **Phone:** (623) 025-1755
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Khakwani And Mohammad Medical PC (NPI 1255046918, Buckeye, AZ); Vein Envy LLC (NPI 1225528565, Litchfield Park, AZ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** March 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1366145591) · Data from the CMS NPPES public registry.