Philip L Wackel

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

58258 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905-0001

Phone

(507) 284-2511

NPI assigned

Jun 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, ND, WI, NE, FL5 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

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Nebraska College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winneshiek Medical CenterGroup PAC ID 4688582935, 99 clinicians

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• Direct secure messaging: pwackel113080@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment Care Compare group NPD
• Winneshiek Medical Center

  • Primary Care Clinic/Center
  • Mabel, MN
  • NPI 1093857393
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Fairmont

  • Multi-Specialty Clinic/Center
  • Fairmont, MN
  • NPI 1366410862
  Medicare reassignment NPD
• Mayo Clinic Health System-Lake City

  • Multi-Specialty Clinic/Center
  • Lake City, MN
  • NPI 1164463659
  Medicare reassignment NPD
• Mayo Clinic Health System-Lake City

  • Critical Access Hospital
  • Lake City, MN
  • NPI 1538113022
  Medicare reassignment NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  • Multi-Specialty Clinic/Center
  • Albert Lea, MN
  • NPI 1891701637
  Medicare reassignment NPD
• Mayo Clinic Health System-St James

  • Multi-Specialty Clinic/Center
  • Saint James, MN
  • NPI 1023177730
  Medicare reassignment NPD
• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Medicare reassignment NPD
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment NPD
• Father Flanagan'S Boys' Home

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825
  Medicare reassignment NPD
• Mayo Clinic Arizona

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558332494

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1982800645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKEL",
        "first_name": "PHILIP",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "58258",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "107551",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "57540",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "ND",
            "license": "13518",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "58258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwackel113080@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Huy Gia Vuong, MD, PHD
• Samantha Quyen Vuong, MD
• W-L Home Healthcare
• Mara Kathryn Waaraniemi, PA
• Debra Lynn Wacholz, BS, LADC
• Levi James Waddell
• Sarah Waddell, RN
• Mark Waddle, MD
• Todd W Wade, M.D.
• Karen E Wadel, PT

• Pediatric Cardiology Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Pediatric Cardiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.