Archana G Wagle, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

036100676 Issued in IL

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(309) 779-5000

NPI assigned

Jan 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA, IL2 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 2

Specialty

AnesthesiologyAlso: Interventional Pain Management, Pain Management

Education

University of Kansas School of Med (KC/Wich/Sal), 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awagle92552@direct.unitypoint.org

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.

• Archana Wagle M D a Professional Corporation

  • Interventional Pain Medicine Physician
  • Moline, IL
  • NPI 1720303605

  Anesthesiology, IA, IL

  Medicare reassignment NPD Authorized official
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226

  Interventional Pain Medicine

  NPD

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

• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604

  Hospital

  Care Compare affiliation
• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632

  Hospital

  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1366421968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450689",
            "telephone_number": "847-615-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGLE",
        "first_name": "ARCHANA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036100676",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036100676",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036100676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100676",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0546036",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Eric Vogel-Wilson
• Heidi Vorac
• Sandra J Voss, LSW, LMSW
• Jack G Vukov, MD
• Danielle Jillian Waddle, LMSW
• Nikhil Sudhakar Wagle, MD
• Haley Wagler
• Kylie Waldbusser
• Walgreen Co
• Walgreen Co

• All providers in Rock Island, IL
• Interventional Pain Medicine Physician in Illinois

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