TRAVIS WALLER MD
NPI 1568705879
Pediatrics in Yokosuka, JAPAN
About Travis Waller Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRAVIS WALLER MD (NPI 1568705879) is an individual pediatrics provider in Yokosuka, JAPAN, licensed in Missouri (2014023894) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Travis Waller Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Travis Waller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dededo, GU 96929
- Reassigned Medicare billing, Guam enrollment
- 432 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PSC 475 BX1, FPO-AP 96350
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 Travis Waller's NPI number?
The NPI number for Travis Waller is 1568705879. It was assigned to this individual provider in the NPPES registry on April 4, 2013.
Where is Travis Waller located?
Travis Waller practices at Naval Hospital Yokosuka, Yokosuka, JAPAN 96350. The listed phone number is (936) 552-6503.
What is Travis Waller's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Travis Waller enrolled in Medicare?
Yes. Travis Waller is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Travis Waller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Travis Waller reassigns Medicare benefits to Guam Healthcare Development Incorporated (Dededo, GU). 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 Travis 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 Travis Waller was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Travis Waller, MD · NPI 1568705879
Pediatrics physician in Yokosuka, JAPAN. Individual provider, active in the CMS NPPES registry since April 4, 2013.
## Identity
- **NPI:** 1568705879 (Entity type: Individual)
- **Enumerated:** April 4, 2013
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 2014023894 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** NAVAL HOSPITAL YOKOSUKA, Yokosuka, JAPAN 96350
- **Phone:** (936) 552-6503
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Guam Healthcare Development Incorporated (NPI 1326447939, Dededo, GU), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 18, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1568705879) · Data from the CMS NPPES public registry.