Petter Andre Vaagenes, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34.009309 Issued in OH

Practice address

1320 W Main St
Newark, OH 43055-1822

Phone

(220) 564-4144

Fax

(220) 564-7153

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, TX2 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 2

Merit-based Incentive Payment System (MIPS)

Final score

85.98 of 100Reported as group

Quality

75.66

Promoting interoperability

100

Improvement activities

40

Cost

75.38

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Community Hospitalist, LLC

  • Hospitalist Physician
  • Lorain, OH
  • NPI 1538236872
  Medicare reassignment NPD
• Knox Emergency Services, LLC

  • Emergency Medicine Physician
  • Mount Vernon, OH
  • NPI 1861450066
  Medicare reassignment NPD
• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265
  Medicare reassignment NPD
• Round Table Physicians Group PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bellaire, TX
  • NPI 1023439114
  Medicare reassignment NPD
• Licking Memorial Professional Corporation

  dba Licking Memorial Orthopedic DME

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD
• Licking Memorial Professional Corporation

  dba Licking Memorial Pathologists

  • Anatomic Pathology & Clinical Pathology Physician
  • Newark, OH
  • NPI 1932186053
  NPD
• Round Table Specialist Group, PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1497152268
  NPD
• Fairfield ER Physicians Dba Fairfield Medical Center Pro Fee

  • Emergency Medicine Physician
  • Lancaster, OH
  • NPI 1942233879
  NPD (past)
• Licking Memorial Professional Corp.

  dba Licking Memorial Pediatrics-Utica

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1982810289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4144",
            "fax_number": "220-564-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4144",
            "fax_number": "220-564-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAAGENES",
        "first_name": "PETTER",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.009309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2933151",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twelve Partners Group, LLC
• Ori Tzuk, MD
• Anne M Underwood
• Urological Center, Inc
• Latha Urs, MD
• Sarah Van Runkle
• Jeannie I Vance
• Kari Marie Vance, NP-C
• Haley Vansickle
• Jade Marie Vanwashenova

• Emergency Medicine Physician in Newark, OH
• Providers in Newark, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.