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

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: November 01, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Wakim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northeast Valley Health Corporation
Same address
Federally Qualified Health Center (FQHC)
1600 SAN FERNANDO RD
San Fernando, CA 91340
  • Reassigned Medicare billing, California enrollment
  • 218 clinicians in this Medicare group
NPI 1235130600 (818) 365-8086

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
MS. REBECCA LEE CROSS N.P.
Nurse Practitioner (Family)
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
MR. ALBERT MEDINA PASCUAL M.D.
Internal Medicine
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
LARA ACCAD ABBOTT M.D.
Pediatrics
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
DR. RYAN ZHONG-WEI HUANG I DDS
Dentist
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 898-1388
AQEELA ATHAR RDH
Dental Hygienist
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
LARISA GORELIK PHARMACIST
Pharmacist
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086
SILVIA DARIE M.D.
Internal Medicine
1600 SAN FERNANDO RD
SAN FERNANDO, CA 91340
Los Angeles County (818) 365-8086

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 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.

Where is Mary Wakim located?

Mary Wakim practices at 1600 San Fernando Rd, San Fernando, CA 91340. The listed phone number is (818) 365-8086.

What is Mary Wakim's specialty?

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

Is Mary Wakim enrolled in Medicare?

Yes. Mary Wakim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Wakim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Wakim reassigns Medicare benefits to Northeast Valley Health Corporation (San Fernando, 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 Mary Wakim'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 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.