Cameron Bradley Waller, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

02006682A Issued in IN

Practice address

600 Mary Street
Evansville, IN 47747-1972

Phone

(812) 450-2240

Fax

(812) 450-2710

NPI assigned

Mar 24, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 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

Specialty

Anesthesiology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Hospital, Inc.Group PAC ID 9032021431, shared by 11 NPIs, 410 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
• Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056

Merit-based Incentive Payment System (MIPS)

Final score

87.17 of 100Reported as group

Quality

82.57

Promoting interoperability

100

Improvement activities

40

Cost

71.91

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Deaconess Hospital, Inc

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  Medicare reassignment NPD
• Deaconess Hospital Inc

  • Pulmonary Disease Physician
  • Owensboro, KY
  • NPI 1841822327
  Medicare reassignment NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552
  NPD
• Deaconess Hospital, Inc

  • Anesthesiology Physician
  • Evansville, IN
  • NPI 1629162573
  NPD

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

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation
• Methodist Health, Inc.

  • General Acute Care Hospital
  • Henderson, KY
  • NPI 1083759633
  Care Compare affiliation

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1700346830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3366",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477323366",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477471972",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "CAMERON",
        "middle_name": "BRADLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "02006682A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Wallace
• Derek Wallace
• Destiny Wallace
• Paris Wallace
• Patricia G Wallace, CNS
• Charlotte Waller, LMHC
• James D Waller Jr., MD
• Sherri A Walling, NP
• Fredrick H Wallisch, M.D.
• Jenna Marie Walls, COTA

• Anesthesiology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.

Verify at the official NPI Registry.