DR. MARY ELLEN WAKIM M.D.
NPI 1720089337
Pediatrics in San Fernando, CA

Q: What is Mary Wakim's NPI number?

The NPI number for Mary Wakim is 1720089337. It was assigned to this individual provider in the NPPES registry on August 4, 2005.

Q: What is Mary Wakim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Wakim was last updated on April 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since August 04, 2005PECOS Enrolled

1600 SAN FERNANDO RD, SAN FERNANDO, CA 91340(818) 365-8086(818) 898-4826 Get Directions Write a Review

NPPES record last updated: April 15, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Mary Ellen Wakim M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARY ELLEN WAKIM M.D. (NPI 1720089337) is an individual pediatrics provider in San Fernando, California, licensed in California (G6859) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720089337

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. MARY ELLEN WAKIMCredential: M.D.

Location Address1600 SAN FERNANDO RDSan Fernando, CA 91340-3115

Mailing Address1172 N Maclay AveSan Fernando, CA 91340-1328 · (818) 898-1388 · Fax (818) 365-4031

Phone(818) 365-8086

Fax(818) 898-4826

Sole ProprietorNo

Enumeration DateAugust 4, 2005

Last NPPES UpdateApril 15, 2013

✔ NPI 1720089337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · G6859

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1600 SAN FERNANDO RD, San Fernando, CA 91340

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Other Identifiers 1

Medicare UPING69453

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Ellen Wakim M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91340 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SUSAN EGLICK LEVY M.D.

Pediatrics