Stanley Edward Wandeloski Jr., D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101021580 Issued in MI

Practice address

1000 Harrington St
Mount Clemens, MI 48043-2920

Phone

(586) 493-8000

NPI assigned

Jun 28, 2015

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Lapeer Region Hospital, Lapeer, MI, CCN 230193

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• McLaren Hospital Group

  • Emergency Medicine Physician
  • Flint, MI
  • NPI 1942026174
  Medicare reassignment Care Compare group NPD
• Degara App, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1265976971
  Medicare reassignment NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066

  Emergency Medicine

  Medicare reassignment NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD

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

• McLaren Lapeer Region

  • General Acute Care Hospital
  • Lapeer, MI
  • NPI 1205824737
  Care Compare affiliation

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1831571678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDELOSKI",
        "first_name": "STANLEY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-28",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Walny, MA, LLPC, CAADC-DP
• James Robert Walsdorf
• Michael Walsh
• Hannah Walters
• Richard Green Walton, DO
• Aurora Ward, LLMSW
• Eudora D Ward, N/A
• Denise M Warnack, MA LPC
• Jacob Warwinsky
• Nirmin Botros Wasef, CPSS

• Emergency Medicine Physician in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2015; 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.