Individual provider Active NPI

Wayne K Kawalek, MD

  • Addiction Medicine (Family Medicine) Physician
  • Oakwood Village, OH
National Provider Identifier
1063514784
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
AK35046206 Issued in OH
Practice address
7601 First PL
Oakwood Village, OH 44146-6716
Phone
(440) 552-9454
Fax
(440) 945-6368
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35-04-6206 OH
Addiction Medicine (Family Medicine) Physician 207QA0401X AK35046206 OH Primary

Addresses

Primary practice location

7601 First PL
Oakwood Village, OH 44146-6716

Mailing address

7601 First PL Ste 7a
Oakwood Village, OH 44146-6702
Phone (440) 552-9454

Other identifiers 1

IdentifierTypeStateIssuer
0056326MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AK35046206OHMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Erie Seniors, Inc. Past Accepting new patients
Erie Banks Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1063514784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 FIRST PL STE 7A",
            "city": "OAKWOOD VILLAGE",
            "state": "OH",
            "postal_code": "441466702",
            "telephone_number": "440-552-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 FIRST PL",
            "city": "OAKWOOD VILLAGE",
            "state": "OH",
            "postal_code": "441466716",
            "telephone_number": "440-552-9454",
            "fax_number": "440-945-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWALEK",
        "first_name": "WAYNE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-04-6206",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "AK35046206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056326",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakwood Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.