Individual provider Active NPI

David Anthony Wacker, M.D., PH.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Minneapolis, MN
National Provider Identifier
1386969327
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
60619 Issued in MN
Practice address
401 E River Pkwy
Suite 350, VCRC
Minneapolis, MN 55455-0368
Phone
(612) 624-0999
Fax
(612) 625-2174
NPI assigned
Apr 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60619 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 60619 MN Primary

Addresses

Primary practice location

401 E River Pkwy
Suite 350, VCRC
Minneapolis, MN 55455-0368

Mailing address

420 Delaware St SE
MMC 276
Minneapolis, MN 55455-0341
Phone (612) 624-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20160630000861 MN Practitioner - Critical Care (Intensivists) 0749572394 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Yale University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
60619MNMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Mar 1, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 20, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Care System CurrentSince Mar 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 31, 2016 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Mar 1, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 31, 2016 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 31, 2016 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jun 20, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

420 Delaware St SE
#276
Minneapolis, MN 55455
Phone (612) 624-0999

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

6405 France Ave S
Minneapolis, MN 55435
Phone (952) 924-9005

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

2849 Johnson St NE
Minneapolis, MN 55418
Phone (612) 672-1900

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: dwacker380344@fairview.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1386969327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 276",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-624-0999",
            "fax_number": "612-625-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E RIVER PKWY",
            "address_2": "SUITE 350, VCRC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550368",
            "telephone_number": "612-624-0999",
            "fax_number": "612-625-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-01",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "60619",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "60619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.