Individual provider Active NPI

David L Waxman, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Bridgeport, WV
National Provider Identifier
1174563092
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
14240 Issued in WV
Practice address
527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010
Phone
(681) 342-3550
Fax
(681) 342-3507
NPI assigned
Jun 8, 2006
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 14240 WV
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 14240 WV Primary

Addresses

Primary practice location

527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010

Mailing address

527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010
Phone (681) 342-3550

Other identifiers 6

IdentifierTypeStateIssuer
200004627OtherRAILROAD MEDICARE
WV2679AOtherWVMEDICARE PTAN
WV14240BOtherHEALTH PLAN OHIO VALLEY
001720802OtherBLUE CROSS
0097123000MedicaidWV
1362317OtherUMWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dwaxman722@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address dwaxman722@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20040305001131 WV Practitioner - Orthopedic Surgery 3971491523 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Maryland School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

10 Amalia Dr
Suite C8
Buckhannon, WV 26201-2270
Phone (304) 460-7959

107 Staunton Dr
Weston, WV 26452-5604
Phone (681) 342-3870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement26
Knee replacement78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of Buckhannon Inc CurrentSince Oct 1, 2019 Accepting new patients
Wvu Medical Corporation Orthopaedic Surgery CurrentSince Oct 30, 2010 Accepting new patients
West Virginia University Medical Corporation CurrentSince Oct 30, 2010 Accepting new patients
West Virginia University Medical Corporation Orthopaedic Surgery Current Accepting new patients
United Hospital Center Inc Orthopaedic Surgery CurrentSince Apr 1, 2013 Accepting new patients
United Hospital Center, Inc. Orthopaedic Surgery CurrentSince Apr 1, 2013 Accepting new patients
Wvu Medical Corporation Past Accepting new patients
United Hospital Center Past Accepting new patients
Fairmont Physicians Inc Past Accepting new patients
St Josephs Hospital of Buckhannon Orthopaedic Surgery PastSince Oct 1, 2019 Accepting new patients

Locations

227 Medical Park Dr
Ste 101
Bridgeport, WV 26330
Phone (681) 342-3490

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

527 Medical Park Dr
Ste 302
Bridgeport, WV 26330
Phone (304) 933-3928

527 Medical Park Dr
Ste 400
Bridgeport, WV 26330
Phone (681) 342-1610

527 Medical Park Dr
Ste 500
Bridgeport, WV 26330
Phone (681) 342-3600

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

10 Amalia Dr
Ste C4
Buckhannon, WV 26201
Phone (304) 460-7936

10 Amalia Dr
Ste C8
Buckhannon, WV 26201
Phone (304) 460-7959

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

107 Staunton Dr
Weston, WV 26452
Phone (304) 269-2022

Organizations & group practices 10

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

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1174563092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3550",
            "fax_number": "681-342-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3550",
            "fax_number": "681-342-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "14240",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "WV",
            "license": "14240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200004627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV2679A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OHIO VALLEY",
            "identifier": "WV14240B",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001720802",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097123000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1362317",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwaxman722@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "227 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263308420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwaxman722@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "227 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263308420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.