NPIMap

Individual provider Active NPI

Peter William Waldusky, MD

  • Hospitalist Physician
  • Saint Cloud, MN
National Provider Identifier
1194714097
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
44863 Issued in MN
Practice address
1200 Sixth Ave N
St Cloud, MN 56303-2735
Phone
(320) 251-2700
Fax
(320) 240-2118
NPI assigned
Oct 14, 2005
Last updated
Oct 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44863 MN
Hospitalist Physician 208M00000X 44863 MN Primary

Addresses

Primary practice location

1200 Sixth Ave N
St Cloud, MN 56303-2735

Mailing address

1200 Sixth Ave N
St Cloud, MN 56303-2735
Phone (320) 251-2700

Other identifiers 9

IdentifierTypeStateIssuer
1628854OtherARAZ GROUP/AMERICA'S PPO
315339800OtherMEDICAL ASSISTANCE
0404593OtherMEDICA HEALTH PLANS
141884OtherU-CARE
HP35324OtherHEALTH PARTNERS
315339800MedicaidMN
1031038OtherPREFERRED ONE
2113976OtherFIRST HEALTH PLAN
60G47WAOtherBLUE CROSS BLUE SHIELD

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
I20101012000727 MN Practitioner - Internal MedicinePractitioner - Hospitalist 7012109895 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Minnesota Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare Health System-NR LLCGroup PAC ID 3870739410, shared by 4 NPIs, 63 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians
Centracare Health-Paynesville LLCGroup PAC ID 1153555719, shared by 4 NPIs, 61 clinicians

Practice addresses (Care Compare)

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 295-2945

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1406 6TH Ave N
St Cloud, MN 56303-1901

1406 6TH Ave No
St Cloud, MN 56303-1901

200 W 1St St
Paynesville, MN 56362-1445
Phone (320) 243-3767

50 Centracare Dr
Long Prairie, MN 56347-2100
Phone (320) 732-2141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44863MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health - Benson LLC CurrentSince Apr 1, 2025 Accepting new patients
Centracare Clinic Current Accepting new patients
Carris Health LLC CurrentSince Jan 1, 2026 Accepting new patients
Centracare Health System - Long Prairie CurrentSince Jul 9, 2023 Accepting new patients
Swift County Benson Hospital Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Jan 1, 2026 Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Jul 1, 2025 Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Nov 13, 2019 Accepting new patients
Centracare Health - Benson LLC Current Accepting new patients
Centracare Clinic CurrentSince Aug 11, 2002 Accepting new patients
Carris Health - Redwood LLC CurrentSince Feb 1, 2024 Accepting new patients
Carris Health - Redwood LLC CurrentSince Feb 1, 2024 Accepting new patients
Carris Health LLC CurrentSince Jan 1, 2026 Accepting new patients
Redwood Area Hospital Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Nov 13, 2019 Accepting new patients
Centracare Health-Paynesville LLC Current Accepting new patients
Centracare Clinic CurrentSince Aug 11, 2002 Accepting new patients
Centracare Health - Benson LLC CurrentSince Apr 1, 2025 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Jul 1, 2025 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Jan 1, 2026 Accepting new patients
Minnesota Pathologists Chartered Current Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

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

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

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

101 Caring Way
Redwood Falls, MN 56283
Phone (507) 637-2911

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

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

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

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

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: pwaldusky1629@direct.centracare.com

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 10

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1194714097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-251-2700",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-251-2700",
            "fax_number": "320-240-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDUSKY",
        "first_name": "PETER",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "44863",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "44863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP/AMERICA'S PPO",
            "identifier": "1628854",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "315339800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "0404593",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "141884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP35324",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315339800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1031038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "2113976",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60G47WA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.