Jesse Julian Waggoner, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

A110151 Issued in CA

Practice address

1301 Shoreway Rd
Suite 100
Belmont, CA 94002-4151

Phone

(650) 596-7000

Fax

(650) 596-7096

NPI assigned

Apr 28, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• AL HMO
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• AL HMO D-SNP
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1003081357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SHOREWAY RD",
            "address_2": "SUITE 100",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024151",
            "telephone_number": "650-596-7000",
            "fax_number": "650-596-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHOREWAY RD",
            "address_2": "SUITE 100",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024151",
            "telephone_number": "650-596-7000",
            "fax_number": "650-596-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "JESSE",
        "middle_name": "JULIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A110151",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A110151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romana Usman, M.D.
• Isabelle Valderrama
• Sean Vincent Vallor, LMFT, APC
• Vincent Kan, L.Ac. Inc.
• Esther Voss
• Walgreen Co
• Desirae Perouz Walker, CADC-CAS
• Juan N Walterspiel, MD, FAAP
• Lisa Anne Warren, OTR/L
• Watson Advanced Chiropractic, Inc

• Infectious Disease Physician in Belmont, CA
• Providers in Belmont, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.