Eric J Wannamaker, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

62401 Issued in AZ

Practice address

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

Phone

(480) 301-8000

NPI assigned

May 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, MN, AZ3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

University of Colorado School of Medicine, Aurora, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewannamaker1971726@ehrdirect.mayoclinicmsg.org
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Mayo Clinic Arizona

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558332494
  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  CO, Diagnostic Radiology

  Medicare reassignment NPD
• Blue Ridge Healthcare Medical Group Inc

  • Diagnostic Radiology Physician
  • Morganton, NC
  • NPI 1639244478

  CO

  Medicare reassignment NPD
• Minneapolis Radiology Associates, LTD.

  • Diagnostic Radiology Physician
  • Robbinsdale, MN
  • NPI 1871594341
  Medicare reassignment NPD
• Minnesota Diagnostic Imaging Partners, LLC

  • Diagnostic Radiology Physician
  • Maple Grove, MN
  • NPI 1922009471
  Medicare reassignment NPD
• Norton Clark Physician Practices, LLC

  • Internal Medicine Physician
  • Clarksville, IN
  • NPI 1083098651

  CO

  Medicare reassignment NPD
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502
  Medicare reassignment NPD
• Radiant Imaging, Inc.

  • Diagnostic Radiology Physician
  • Arcadia, CA
  • NPI 1437583200

  CO

  Medicare reassignment NPD
• Mayo Clinic Arizona

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1699520049
  NPD
• Blue Ridge Healthcare Medical Group, Inc.

  • Internal Medicine Physician
  • Morganton, NC
  • NPI 1578424685
  NPD
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Superior, CO
  • NPI 1336870856
  NPD
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513
  NPD (past)

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

• Mayo Clinic Arizona

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1154392231
  Care Compare affiliation

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1245619808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12631 E 17th Ave",
            "address_2": "Mailstop 8200",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452527",
            "country_code": "US",
            "telephone_number": "303-724-1989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANNAMAKER",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-28",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0064273",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "62401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewannamaker1971726@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shouwen Wang, M.D.
• Tingrui Wang, M.D.
• Winni Wang, PHARMD
• McKenna Wangen
• Francine Wanjiku
• Aman Wanore
• Amanda J Waradzin, M.S.ED., CCC-SLP
• Kethes C. Waram, MD
• Warby Parker Inc.
• Kristina Ward Deshler, LMFT

• Diagnostic Radiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.