MR. WADE GARRET FUECONCILLO
NPI 1912496423
Physician Assistant in Colton, CA

Q: What is Wade Fueconcillo's NPI number?

The NPI number for Wade Fueconcillo is 1912496423. It was assigned to this individual provider in the NPPES registry on May 10, 2018.

Q: What is Wade Fueconcillo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Wade Fueconcillo was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 May 10, 2018PECOS EnrolledAccepts Medicare Assignment

400 N PEPPER AVE, COLTON, CA 92324(909) 580-1775 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 6, 2021, Aug 4, 2020, Jan 24, 2019 and 2 more (5 updates tracked since 2018).

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About Mr. Wade Garret Fueconcillo NPPES

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

MR. WADE GARRET FUECONCILLO (NPI 1912496423) is an individual physician assistant in Colton, California and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1912496423

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. WADE GARRET FUECONCILLO

Location Address400 N PEPPER AVEColton, CA 92324-1801

Mailing Address341 Magnolia Ave Ste 101Corona, CA 92879-3331 · (951) 256-8150 · Fax (951) 735-4510

Phone(909) 580-1775

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 10, 2018

Last NPPES UpdateDecember 6, 20215 updates tracked since enumeration

NPPES CertifiedAugust 4, 2020

✔ NPI 1912496423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License PA55900 (CA)

400 N PEPPER AVE, Colton, CA 92324

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Wade Garret Fueconcillo 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.

PECOS PAC ID1951649862

PECOS Enrollment IDI20190218002747

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 92324 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

Most-billed visit code 99213

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.

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