Eric Waetjen, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

342862 Issued in LA

Practice address

1747 Imperial Blvd
Lake Charles, LA 70605-5362

Phone

(337) 721-7236

Fax

(337) 721-7237

NPI assigned

Jun 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

General Surgery

Education

University of Texas Medical School at San Antonio, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Orthopaedics and Spine LLCGroup PAC ID 1557797206, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
• Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewaetjen433459@christushealth.direct-ci.net

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.

• Center for Orthopaedics and Spine LLC

  • Orthopaedic Surgery Physician
  • Lake Charles, LA
  • NPI 1538703335
  Medicare reassignment Care Compare group NPD
• Center for Orthopaedics and Spine LLC

  • Orthopaedic Surgery Physician
  • Lake Charles, LA
  • NPI 1134877392
  NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1093927105

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1205040995

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Grand Chenier, LA
  • NPI 1407068299

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • General Acute Care Hospital
  • Lake Charles, LA
  • NPI 1629076468
  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1710191473

  Hospital

  Care Compare affiliation
• Hospital Service District No 2 of Parish of Beauregard State of la

  • Rural Acute Care Hospital
  • Deridder, LA
  • NPI 1831193499
  Care Compare affiliation

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1831540608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAETJEN",
        "first_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2016020253",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "342862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI",
            "identifier": "2016020253",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• W O Moss Regional Medical Center
• W O Moss Regional Medical Center
• W.O. Moss Regional Medical Center
• Kenneth Joseph Waddell
• Ka'Dea Wade-George, FNP
• C. Eliska Wagnon
• Jennifer Ashley Wainwright, APRN, FNP-C
• Wal-Mart Stores East , LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Surgery Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.