WAYNE ALBERT WIVELL (NPI# 1912980079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912980079 |
| Entity Type | Individual |
| Full Name | WAYNE ALBERT WIVELL |
| Credential | MD |
| Practice Address |
585 Lebanon Street Melrose-wakefield Hospital Melrose MA 02176 |
| Mailing Address |
6716 Nw 11th Pl Ste 200 Gainesville FL 32605-4201 |
| Practice Telephone | 7819793120 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME145109 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
81971 | MA | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
81971 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | MQ512 | 01 |
| FL | MEDICARE | MQ511 | 01 |
| FL | 106807000 | 05 |
| Street Address |
585 LEBANON STREET MELROSE-WAKEFIELD HOSPITAL |
| City | MELROSE |
| State | MA |
| Zip Code | 02176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841716503 | Rachel Nicole Lehouillier | Nurse Practitioner | 585 Lebanon Street, Melrose, MA 02176 | 2017-08-15 |
| 1639591829 | Sara Breglio | Physician Assistant | 585 Lebanon Street, Emergency Department, Attn: Sara Breglio Pa-c, Melrose, MA 02176-5257 | 2014-01-08 |
| 1033398292 | Mike H Summerer | Internal Medicine | 585 Lebanon Street, Hallmark Health System, Melrose, MA 02176 | 2007-10-24 |
| 1821284274 | Bin He | Internal Medicine | 585 Lebanon Street, Melrose, MA 02176 | 2007-09-19 |
| 1205036712 | Katherine Anne Bourne | Anesthesiology | 585 Lebanon Street, Melrose, MA 02176-3224 | 2007-07-23 |
| 1154368355 | Evan R Berman | Anesthesiology | 585 Lebanon Street, Melrose Wakefield Hospital, Melrose, MA 02176 | 2006-05-31 |
| 1417919168 | Hisham S El-kadi | Anesthesiology | 585 Lebanon Street, Anesthetics of Massachusetts, PC, Melrose, MA 02176 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384826 | Edrine Astremont | Registered Nurse | 414 Malden, Massachusetts, NY 02176 | 2020-07-23 |
| 1194203919 | Caroline Bregman | Social Worker | 12 Howard St, Melrose, MA 02176 | 2018-08-02 |
| 1386167682 | Carmen Alicia Fernandez | Community/Behavioral Health | 24 Lynde St, Melrose, MA 02176 | 2017-07-19 |
| 1518316116 | Sheila Kelley | Physical Therapist | 15 Green Street, Melrose, MA 02176 | 2016-06-06 |
| 1083049712 | Randi A Brown | Counselor | 610 A Main Street, Melrose, MA 02176 | 2013-09-12 |
| 1306121488 | Frank Anthony Pennacchio | Pharmacist | 17 Coolidge Road, Melrose, MA 02176 | 2011-10-20 |
| 1245401751 | Meaghan Rudolph | Registered Nurse | 11 Stratford Rd, Melrose, MA 02176 | 2008-03-13 |
| 1104039726 | Judy E Bushee | Custodial Care Facility | The Toole Nursing Home, 92 Franklin Street, Melrose, MA 02176 | 2007-05-08 |
| 1811012776 | Mark Joseph Gianatassio | Dentist | 820 Lynn Fells, Melrose, MA 02176 | 2007-03-20 |
| 1154452993 | City of Melrose | Local Education Agency (LEA) | 360 Lynn Fells Parkway, Melrose, MA 02176 | 2007-03-07 |
| Find all providers in zip 02176 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043348683 | Nam Lee | Radiology | 1 Oak Grove Ave, 132, Melrose, MA 02176-6121 | 2007-03-02 |
| 1114555398 | Mw Radiology-cra LLC | Radiology | 585 Lebanon St, Melrose, MA 02176-3225 | 2020-04-01 |
| 1316059082 | Hallmark Imaging Associates, PC | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-08-31 |
| 1336183672 | Olga Efimova | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-06-16 |
| 1063456309 | Karl Eric Henrikson | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-06-16 |
| 1730123076 | Patrick D Oder | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-06-16 |
| 1801830153 | Coralli R So | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-06-16 |
| 1982648234 | Esther E Sreter | Radiology | 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | 2006-06-16 |
| 1013975671 | Joshua P Stein | Radiology | 585 Lebanon St, Hallmark Imaging, Melrose, MA 02176-3225 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604570 | Yarab Mubarak Habib Al Bulushi | Radiology | 330 Brookline Ave Dept of Radiology, Boston, MA 02215-5400 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1417507740 | Daniel Andres Vargas Zapata | Radiology | 330 Brookline Ave # Es-215, Boston, MA 02215-5491 | 2019-09-18 |
| 1386129468 | Keri Susan Bouthiller | Radiology | 9 Stevens St, Stoneham, MA 02180-1806 | 2018-09-25 |
| 1851870992 | Robert Kevin Moreland | Radiology | 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02120 | 2018-08-09 |
| 1790270239 | Rahul Gujrathi | Radiology | 450 Brookline Ave Dana-farber Cancer Institute, Department of Imaging Dl-198, Boston, MA 02215 | 2018-06-27 |
| 1083104434 | Edgar Leonardo Martinez-salazar | Radiology | 20 Michigan Ave, Somerville, MA 02145-2228 | 2018-05-11 |
| 1548758790 | Hudson Valley Radiologists, PC | Radiology | 18 West Rd, Great Barrington, MA 01230-1947 | 2018-04-24 |
| 1700381282 | Casey Keith Bishop | Radiology | 820 Harrison Ave Dept Of, Boston, MA 02118-2905 | 2018-03-27 |
| 1922517713 | Arwa Alzaghal | Radiology | Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115 | 2017-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.