Richard John Waclawski, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23560 Issued in NE

Practice address

340 Hulse Rd
Pensacola, FL 32508-1089

Phone

(850) 452-2458

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwaclawski191308@direct.llu.edu

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.

• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  Medicare reassignment NPD
• Orion Anesthesia Consultants Inc

  • Anesthesiology Physician
  • Murrieta, CA
  • NPI 1649585001
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• First Choice Physician Partners

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1558797118
  NPD
• First Choice Physician Partners

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892

  General Practice

  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1568429306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 RAWHIDE WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920576507",
            "telephone_number": "760-967-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HULSE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325081089",
            "telephone_number": "850-452-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACLAWSKI",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "23560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Suzanne Voss
• Nicholas Vu, PHARM.D.
• Yelena Sergeevna Vuyovich, ARNP
• Bryan Vyverberg, M.D.
• W H Hansen MD PA
• Carolyn Waddell, PA-C
• Joshua Waddell, APRN
• Barbara H Wade, MD
• David Wade Jr.
• Jessica Wade, ARNP

• General Practice Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.