Individual provider Active NPI

Douglas Jerome Waffen, M.D.

  • Emergency Medicine Physician
  • Tripler AMC, HI
National Provider Identifier
1609858794
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11266 Issued in HI
Practice address
1 Jarrett White Rd
Tripler Army Medical Center
Tripler AMC, HI 96859-5001
Phone
(808) 433-2460
Fax
(808) 433-1558
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 01080608A IN
Emergency Medicine Physician 207P00000X 11266 HI Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center
Tripler AMC, HI 96859-5001

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001
Phone (808) 433-2460

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 2

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 3

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 4

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 5

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 6

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 7

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 8

450 Washington Jackson Rd
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 9

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 10

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20060320000271 HI Practitioner - Emergency Medicine 3173530912 Reassigns benefits to 3 organizations
I20190709000801 IN Practitioner - Emergency Medicine 3173530912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northwestern University Feinberg Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Emergency Physicians Associated IncGroup PAC ID 2860390283, 119 clinicians

Practice addresses (Care Compare)

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4730

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11266HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honokaa Hospital & Skilled Nursing CurrentSince Sep 20, 2025 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Apr 23, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Kau Hospital CurrentSince Sep 20, 2025 Accepting new patients
Kau Hospital CurrentSince Sep 20, 2025 Accepting new patients
Honokaa Hospital & Skilled Nursing CurrentSince Sep 20, 2025 Accepting new patients
Kau Hospital Current Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients
Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

45-547 Plumeria St
Honokaa, HI 96727
Phone (808) 775-7211

56-117 Pualalea St
Kahuku, HI 96731
Phone (808) 293-9221

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

407 Uluniu St
Fl 4
Kailua, HI 96734
Phone (808) 261-3326

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

9613 E US Highway 36
Avon, IN 46123
Phone (317) 415-5980

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

8602 Allisonville Rd
Indianapolis, IN 46250
Phone (317) 703-1970

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 11

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.

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1609858794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAFFEN",
        "first_name": "DOUGLAS",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01080608A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "11266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tripler AMC, HI

Sources for this page

Verify at the official NPI Registry.