NPIMap

Organization Active NPI

Michael Wadzinski, PC

  • Ophthalmology Physician
  • Sioux City, IA
National Provider Identifier
1629291992
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
29715 Issued in IA
Legal business name
MICHAEL WADZINSKI, PC
Practice address
2800 Pierce St
Suite 404
Sioux City, IA 51104-3759
Phone
(712) 226-3937
Fax
(712) 224-3973
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Dr. Michael Gerard Wadzinski, MDNPI 1982674297
Title
President
Phone
(712) 226-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 29715 IA Primary

Addresses

Primary practice location

2800 Pierce St
Suite 404
Sioux City, IA 51104-3759

Mailing address

PO Box 3564
Sioux City, IA 51102-3564
Phone (712) 226-3937

Other names 1

  • Wadzinski Eye Clinic PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA, SD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070425000589 NE Part B Supplier - Clinic/Group Practice 2062518756 Receives reassigned benefits from 1 practitioner
Practice locations: Norfolk, NE
O20070625000487 IA Part B Supplier - Clinic/Group Practice 2062518756 Receives reassigned benefits from 2 practitioners
Practice locations: Sioux City, IA
O20070723000471 SD Part B Supplier - Clinic/Group Practice 2062518756 Receives reassigned benefits from 1 practitioner
Practice locations: Yankton, SD

National Provider Directory

National Provider Directory

Locations

5855 Sunnybrook Dr
Sioux City, IA 51106
Phone (712) 226-3937

100 W 3rd St
Yankton, SD 57078

Interoperability endpoints

  • Direct secure messaging: mwadzinski@wadzinski.intellechartdirect.net
  • Direct secure messaging: phaeker@wadzinski.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1629291992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3564",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511023564",
            "telephone_number": "712-226-3937",
            "fax_number": "712-224-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 PIERCE ST",
            "address_2": "SUITE 404",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043759",
            "telephone_number": "712-226-3937",
            "fax_number": "712-224-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WADZINSKI, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "WADZINSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-226-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "29715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wadzinski Eye Clinic PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.