Eric William Waldo, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

01067105A Issued in IN

Practice address

1205 Provident Drive
Suite a
Warsaw, IN 46580-3265

Phone

(574) 269-8383

Fax

(574) 269-8384

NPI assigned

Jun 11, 2008

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Internal Medicine

Education

Indiana University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Hospitalist Physicians of Indiana PCGroup PAC ID 1052795986, 148 clinicians

Indiana University Health Ball Memorial Physicians IncGroup PAC ID 9537072640, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089
• Indiana University Health Jay, Inc. Hospital, Portland, IN, CCN 151320
• Marion General Hospital Hospital, Marion, IN, CCN 150011
• Henry County Memorial Hospital Hospital, New Castle, IN, CCN 150030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787

  Internal Medicine

  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD
• Icem-Ball, LLC

  • Emergency Medicine Physician
  • Muncie, IN
  • NPI 1316273691
  NPD (past)
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford City, IN
  • NPI 1245094028
  NPD (past)

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

• Henry County Memorial Hospital

  • General Acute Care Hospital
  • New Castle, IN
  • NPI 1356428429
  Care Compare affiliation
• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation
• Indiana University Health Jay, Inc.

  • Critical Access Hospital
  • Portland, IN
  • NPI 1801315692
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Marion, IN
  • NPI 1770679201
  Care Compare affiliation
• Marion General Hospital

  • Nutrition Support Registered Nurse
  • Marion, IN
  • NPI 1861578072

  Hospital

  Care Compare affiliation
• Marion General Hospital

  • Land Ambulance
  • Marion, IN
  • NPI 1932295466

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1356501514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 PROVIDENT DRIVE",
            "address_2": "SUITE A",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803265",
            "telephone_number": "574-269-8383",
            "fax_number": "574-269-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "ERIC",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01067105A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01067105A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200968810",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eric.waldo@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1205 Provident Drive",
            "address_2": "Suite A",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandy Vogel
• Trisha Marie Vosberg
• Tamara Lynn Wagner, SLP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Kevin D. Waldo Sr., NP
• Alexis Waldron, M.S., CF-SLP
• Walgreen Co
• Diane E Wallace, MD
• Shane Wallen

• Hospitalist Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Hospitalist Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.