Waldo Avello, M.D.
Individual provider Active NPI Gastroenterology Physician · Duluth, MN
NPI 1922057322 · NPPES record last updated Jul 9, 2024
Key facts
- NPI
- 1922057322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 45321 (MN)
- Practice address
- 1012 E 2ND St
Duluth, MN 55805-2200 - Phone
- (218) 249-7940
- Fax
- (218) 249-7949
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 44
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Gastroenterology
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Innovis Health LLC
The Duluth Clinic LTD
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
- Essentia Health St Mary'S Medical Center
- Essentia Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in WI, MN, ND, MT, MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100206000140 | WI | Practitioner - Gastroenterology |
6800939240 | Reassigns benefits to 2 organizations |
| I20100216000640 | MN | Practitioner - Gastroenterology |
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 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benefis Hospitals, Inc. | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| Bronson Methodist Hospital | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| Benefis Hospitals Inc | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
601 John St
Ste M-302
Kalamazoo, MI 49007
Phone (269) 276-0000
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
920 E 1st St
Ste 201
Duluth, MN 55805
Phone (218) 249-7930
1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132
1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690
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) 735-4200
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
- waldo.avello.avewa@slk.direct.slhduluth.com
- wavello237349@direct.aspirus.org
- direct@direct.bronsonhg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 127832 | MT | |
| Gastroenterology Physician | 207RG0100X | EMC0005005 | MI | |
| Gastroenterology Physician | 207RG0100X | 45321 | MN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100017212 | Other | MN | MEDICARE RR |
| 527402800 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct | Bronson Healthcare Group |
Other providers in Duluth, MN
- Austin & Treacy, P.a.
- Helen Dru Austin
- Sarah Elyse Austreng
- Joseph M Autio
- Ellie Rae Avallone
- Jaime Clarise Avenall
- Melina Avinon
- Michelle Ann Aysta
- Marian Joy Azzabi
- B&L Anesthesia
All providers in Duluth, MN · Gastroenterology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.