NPIMap

Individual provider Active NPI

Wayne R Jandik, M.D.

  • Anesthesiology Physician
  • Saint Cloud, MN
National Provider Identifier
1174514731
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38209 Issued in MN
Practice address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone
(320) 251-2700
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38209 MN Primary

Addresses

Primary practice location

1406 6TH Ave N
Saint Cloud, MN 56303-1900

Mailing address

PO Box 725
Saint Cloud, MN 56302-0725
Phone (320) 258-3090

Other identifiers 1

IdentifierTypeStateIssuer
956523000MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wjandik1347@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824001262 MN Practitioner - Anesthesiology 1254221971 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Iowa, RJ & L Carver College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

3701 12TH St N
Suite 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC CurrentSince Jan 1, 2024 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Clinic CurrentSince Oct 1, 2017 Accepting new patients
Centracare Clinic CurrentSince Oct 1, 2017 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2021 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2021 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

3701 12th St N
Ste 202
Saint Cloud, MN 56303
Phone (320) 258-3090

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1174514731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563020725",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDIK",
        "first_name": "WAYNE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "38209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "956523000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjandik1347@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wjandik1347@direct.centracare.com",
            "address_1": "1406 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.