Ricky J Waniger, MD
Individual provider Active NPI Family Medicine Physician · La Crosse, WI
NPI 1366446098 · NPPES record last updated May 15, 2015
Key facts
- NPI
- 1366446098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 29593 (WI)
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 36
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Wisconsin School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gundersen Lutheran Medical Center Inc
St Josephs Health Services Inc
Gundersen Clinic LTD
Moundview Memorial Hospital and Clinics, Inc.
Practice addresses (Care Compare)
1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600
1705 Omaha St
Elroy, WI 53929-9776
Phone (608) 462-8270
226 2ND St N
Lacrescent, MN 55947-1111
Phone (507) 895-6610
301 Railroad Rd
Wonewoc, WI 53968-9425
Phone (608) 464-3575
400 Water Ave
Hillsboro, WI 54634-9054
Phone (608) 489-8000
402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331
610 E Taylor St
PR Du Chien, WI 53821-2109
Phone (608) 326-6466
Hospital & facility affiliations
- Gundersen Lutheran Medical Center
- Gundersen Moundview Hospital and Clinics
- Gundersen St Josephs Hospital and Clinics
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040226001043 | MN | Practitioner - Family Practice | 0143116970 | Reassigns benefits to 2 organizations |
| I20100206000205 | WI | Practitioner - Family Practice | 0143116970 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29593 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moundview Memorial Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| St. Joseph'S Health Services, Inc. | Current |
Accepting new patients | |
| Gundersen Clinic LTD | Current |
Accepting new patients | |
| St. Joseph'S Health Services, Inc. | Current |
Accepting new patients | |
| Memorial Hospital of Boscobel | Current |
Accepting new patients | |
| Gundersen Lutheran Medical Center, Inc | Current |
Accepting new patients | |
| Gundersen Lutheran Express Care, Inc | Current |
Accepting new patients | |
| Moundview Memorial Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Tri-County Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Memorial Hospital of Boscobel | Current |
Accepting new patients | |
| Gundersen Clinic LTD | Current | Accepting new patients | |
| Tri-County Memorial Hospital, Inc. | Current | Accepting new patients | |
| St. Joseph'S Health Services, Inc. | Current |
Accepting new patients | |
| Gundersen Lutheran Medical Center Inc | Current |
Accepting new patients | |
| Gundersen Clinic LTD | Current |
Accepting new patients | |
| Tri-County Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Moundview Memorial Hospital & Clinics, Inc | Family Medicine | Current |
Accepting new patients |
| Gundersen Lutheran Medical Center, Inc. | Family Medicine | Past | Accepting new patients |
| Gundersen Clinic, LTD. | Past | Accepting new patients |
Locations
331 S 3rd St
La Crescent, MN 55947
Phone (507) 895-6610
226 N 2nd St
La Crescent, MN 55947
Phone (507) 895-6610
123 5th Ave SE
Spring Grove, MN 55974
Phone (507) 498-3302
1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600
205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112
402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331
500 N Holmen Dr
Ste 502
Holmen, WI 54636
Phone (608) 399-3091
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681
610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466
18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712
Interoperability endpoints
- rwaniger9119@direct.emplifyhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 29593 | WI | Yes |
Addresses
Primary practice location
1836 South Ave
La Crosse, WI 54601-5429
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31591600 | Medicaid | WI |
Other providers in La Crosse, WI
- Holly Lynn Walters
- Colleen S. Walz
- Darius E Wampler
- Paige Leigh Wandling
- Katherine Joan Wang
- Aaron Ward
- Autumn Marie Ward
- Eric T. Ward
- Janel Lanae Ward
- Jennifer L Ward
All providers in La Crosse, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.