| Richard G Waggener, MD | |
|
3366 Oakdale Ave N, Robbinsdale, MN 55422-2948 | |
| (763) 398-6383 | |
| Not Available |
| Full Name | Richard G Waggener |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 37 Years |
| Location | 3366 Oakdale Ave N, Robbinsdale, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518917830 | NPI | - | NPPES |
| 2136905 | Medicaid | OH | |
| 64325491 | Medicaid | KY | |
| 1054560 | Medicaid | KY | |
| 200114300 | Medicaid | IN | |
| 274540900A | Medicaid | GA | |
| 000000062498 | Other | KY | ANTHEM BLUE FACET |
| 01773615 | Medicaid | NY | |
| 4817171 | Medicaid | MI | |
| XPY200541 | Medicaid | CA | |
| 060794701 | Medicaid | TX | |
| 909773200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 32784 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Memorial Health | Robbinsdale, MN | Hospital |
| Maple Grove Hospital | Maple grove, MN | Hospital |
| Centracare Health - Monticello | Monticello, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Minneapolis Radiology Associates Ltd | 5698661007 | 43 |
| Entity Name | Minneapolis Radiology Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871594341 PECOS PAC ID: 5698661007 Enrollment ID: O20040313000252 |
| Entity Name | West Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053311399 PECOS PAC ID: 7315833720 Enrollment ID: O20040429001479 |
| Entity Name | Minnesota Diagnostic Imaging Partners Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922009471 PECOS PAC ID: 5890681209 Enrollment ID: O20080227000847 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard G Waggener, MD 2800 Campus Dr Ste 10, Plymouth, MN 55441-8812 Ph: (763) 559-2171 | Richard G Waggener, MD 3366 Oakdale Ave N, Robbinsdale, MN 55422-2948 Ph: (763) 398-6383 |
William Nathan Lisberg, MD Radiology Medicare: Medicare Enrolled Practice Location: 3300 Oakdale Ave N, Robbinsdale, MN 55422 Phone: 763-559-2171 Fax: 763-694-9000 | |
Troy Dean Long, MD Radiology Medicare: Medicare Enrolled Practice Location: 3300 Oakdale Ave N, Robbinsdale, MN 55422 Phone: 763-559-2171 Fax: 763-694-9000 | |
Mark Alan Pilot, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3300 Oakdale Ave N, Robbinsdale, MN 55422 Phone: 763-559-2171 Fax: 763-694-9000 | |
Dr. Andrew James Frager, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3400 Meridian Dr, Robbinsdale, MN 55422 Phone: 763-529-9240 | |
Andrew J Ruppert, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3300 Oakdale Avenue North, Robbinsdale, MN 55422 Phone: 763-398-6611 Fax: 763-398-6601 | |
Brian Thomas Larkin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3300 Oakdale Ave N, Robbinsdale, MN 55422 Phone: 763-559-2171 Fax: 763-694-9000 | |
Rachel Tien, APRN, AG-CNS Radiology Medicare: Medicare Enrolled Practice Location: 3300 Oakdale Ave N, Robbinsdale, MN 55422 Phone: 763-520-5200 |