Active NPI
Gregg D Vanderwaerdt, PA-C
- Physician Assistant
- Rochester, MN
National Provider Identifier
1477523769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9762
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9762 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217251800 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gregg.vanderwaerdt@trinityhealthia.medicity.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mitchell County Memorial Hospital
Practice addresses (Care Compare)
616 N 8TH St
Osage, IA 50461-1456
Phone (641) 732-6000
620 N 8TH St
Osage, IA 50461-1456
Phone (641) 732-6100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.53 of 100
- Quality
- 80.98
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.78
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9762 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitchell County Memorial Hospital | Current | Accepting new patients | |
| Mitchell County Memorial Hospital | Current | Accepting new patients | |
| Sanford Health Network | Past | Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Past | Accepting new patients |
Locations
616 N 8th St
Osage, IA 50461
Phone (641) 732-6000
620 N 8th St
Osage, IA 50461
Phone (641) 732-6100
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Osage, IA
- NPI 1033291927
-
- Certified Registered Nurse Anesthetist
- Osage, IA
- NPI 1407925522
-
- Family Medicine Physician
- Tracy, MN
- NPI 1699869875
-
- Critical Access Hospital
- Cresco, IA
- NPI 1730283326
-
- Clinic Pharmacy
- Cannon Falls, MN
- NPI 1699597468
-
- Family Medicine Physician
- Boyden, IA
- NPI 1679726111
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Britt, IA
- NPI 1912938606
-
- Critical Access Hospital
- Osage, IA
- NPI 1033291927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1477523769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERWAERDT",
"first_name": "GREGG",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9762",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "217251800",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gregg.vanderwaerdt@trinityhealthia.medicity.net",
"affiliation": "N",
"endpointDescription": "RHSHC Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "321 8th Ave W",
"city": "Cresco",
"state": "IA",
"country_code": "US",
"postal_code": "521361064",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.