John L Waciuma, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

43260 Issued in MN

Practice address

900 W Clairemont Ave
Eau Claire, WI 54701-6122

Phone

(715) 717-6600

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1194797407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016122",
            "telephone_number": "715-717-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016122",
            "telephone_number": "715-717-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACIUMA",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MN",
            "license": "43260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1985253",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440057700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "822242",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vop Eau Claire II LLC
• Martin J Voss, MD
• Voyage Counseling
• Kelly L Wachewicz, PT
• Lucas Jay Wachewicz, P.T.
• John Wagenknecht Jr., LCSW
• Amanda Wagner
• Caitlin Marie Wagner
• Emily Wagner
• Peter J Wagner, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.