Individual provider Active NPI

Waldo Avello, M.D.

  • Gastroenterology Physician
  • Duluth, MN
National Provider Identifier
1922057322
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
45321 Issued in MN
Practice address
1012 E 2ND St
Duluth, MN 55805-2200
Phone
(218) 249-7940
Fax
(218) 249-7949
NPI assigned
May 10, 2006
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 127832 MT
Gastroenterology Physician 207RG0100X EMC0005005 MI
Gastroenterology Physician 207RG0100X 45321 MN Primary

Addresses

Primary practice location

1012 E 2ND St
Duluth, MN 55805-2200

Mailing address

1012 E 2ND St
Duluth, MN 55805-2200
Phone (218) 249-7940

Other practice location 1

601 John St Ste M-302
Kalamazoo, MI 49007-5357
Phone (269) 349-2266

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, ND, MT, MI5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20100206000140 WI Practitioner - GastroenterologyPractitioner - Internal Medicine 6800939240 Reassigns benefits to 2 organizations
I20100216000640 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 6800939240 Reassigns benefits to 2 organizations
I20230606001397 ND Practitioner - Gastroenterology 6800939240 Reassigns benefits to 1 organization
I20230908003003 MT Practitioner - Gastroenterology 6800939240 Reassigns benefits to 1 organization
I20240830001068 MI Practitioner - Gastroenterology 6800939240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

420 E 1St St
Duluth, MN 55805-1901
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jan 13, 2003 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jan 13, 2003 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Bronson Methodist Hospital CurrentSince Sep 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Benefis Hospitals Inc CurrentSince Aug 15, 2023 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Benefis Hospitals, Inc. CurrentSince Aug 15, 2023 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jan 13, 2003 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M-302
Kalamazoo, MI 49007
Phone (269) 276-0000

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

920 E 1st St
Ste 201
Duluth, MN 55805
Phone (218) 249-7930

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: waldo.avello.avewa@slk.direct.slhduluth.com
  • Direct secure messaging: wavello237349@direct.aspirus.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 3

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1922057322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-7940",
            "fax_number": "218-249-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-7940",
            "fax_number": "218-249-7949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St Ste M-302",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075357",
            "country_code": "US",
            "telephone_number": "269-349-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVELLO",
        "first_name": "WALDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "127832",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "EMC0005005",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "45321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.