Roger K. Waage, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23375 Issued in MN

Practice address

330 N 8TH Ave E
Duluth, MN 55805-2024

Phone

(218) 723-1112

Fax

(218) 723-0015

NPI assigned

Oct 19, 2005

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Duluth Graduate Medical Education Council Inc

  • Family Medicine Physician
  • Duluth, MN
  • NPI 1972585867
  NPD

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942299227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112",
            "fax_number": "218-723-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112",
            "fax_number": "218-723-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAAGE",
        "first_name": "ROGER",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "23375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30226800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "C005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "8T142WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP22430",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "CN1040796006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-15943",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John H Voss, AU.D.
• Tricia Lynn Voss, PHARM D
• William Frank Vouk III, PHARMD, BCGP
• Blai Vue Vue, FNP
• W. Pony Express LLC
• Rebecca Leigh Wachsmuth, CNP
• Erica Marie Wagner, PT
• Linda Rose Wagner
• Madisen Wagner
• Matthew Steven Wagner, MD

• Family Medicine Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.