Physician Compare National (NPI:1831119403)

HEALTHCARE PROVIDER: SCOTT J WADA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831119403
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789675596
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040520000932
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WADA
	Individual professional last name
Provider First Name	SCOTT
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SUTTER BAY MEDICAL FOUNDATION
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4284538778
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2608
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3901 LONE TREE WAY
	Group Practice or individual's line 1 address
City	ANTIOCH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945096200
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050523
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUTTER DELTA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050008
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CALIFORNIA PACIFIC MEDICAL CTR-DAVIES CAMPUS HOSP
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M