Dr Wayland Antonio Easley, DDS is a medicare enrolled "Anesthesiology" provider in Warwick, Rhode Island. His current practice location is
40 Toll Gate Rd, Warwick, Rhode Island. You can reach out to his office (for appointments etc.) via phone at
(401) 749-2345.
Dr Wayland Antonio Easley is licensed to practice in Rhode Island (license number DAPA02663) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770780645.
Healthcare Provider's Profile
Full Name | Dr Wayland Antonio Easley |
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Gender | Male |
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Speciality | Anesthesiology |
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Location | 40 Toll Gate Rd, Warwick, Rhode Island |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1770780645
- Provider Enumeration Date: 07/02/2007
- Last Update Date: 10/12/2008
Medicare PECOS Information:
- PECOS PAC ID: 8123302494
- Enrollment ID: I20170306000726
Medical Identifiers
Medical identifiers for Dr Wayland Antonio Easley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1770780645 | NPI | - | NPPES |
WE57613 | Medicaid | RI | |
0223000 | Other | MA | DORAL : BMC HEALTH PLAN,NEIGHBORHOOD(MA),NETWORK HEALTH, SR. WHOLE HEALTH |
0223000 | Medicaid | MA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | DEN02883 (Rhode Island) | Secondary |
207L00000X | Anesthesiology | DAPA02663 (Rhode Island) | Primary |
207L00000X | Anesthesiology | 2130220 (Massachusetts) | Secondary |
122300000X | Dentist | 21302 (Massachusetts) | Secondary |
122300000X | Dentist | 051644 (New York) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0223000 MASSHEALTH (Massachusetts) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0223000 DORAL DENTAL (Massachusetts) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | AGHDREXEL OMS (Pennsylvania) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wayland Antonio Easley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Wayland Antonio Easley, DDS 69 Governor St, Providence, RI 02906-3008 Ph: (401) 749-2345 | Dr Wayland Antonio Easley, DDS 40 Toll Gate Rd, Warwick, RI 02886-4444 Ph: (401) 749-2345 |
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