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THADDEUS STANLEY WALCZAK M.D. NPI 1538180864


NPI Information

NPI: 1538180864
Provider Name: THADDEUS STANLEY WALCZAK, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
5775 WAYZATA BLVD
SUITE 200
MINNEAPOLIS, MN
ZIP 55416
Phone: (952) 525-4511
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Thaddeus Stanley Walczak, M.D. is a neurology psychiatry neurology in Minneapolis, MN with 42 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Thaddeus Stanley Walczak, M.D. NPI is 1538180864. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduation Year:1982

The provider's business location address is:

5775 WAYZATA BLVD
SUITE 200
MINNEAPOLIS, MN
ZIP 55416-222
Phone: (952) 525-4511
Fax: (952) 525-1560

The NPI 1538180864 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Continuous measurement of brain wave activity with video (veeg), 12-26 hours, with health care professional analysis, interpretation and report (HCPCS:95720)

The enumeration date for this NPI number is 7/22/2006 and was last updated on 9/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology40359MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101014968OTHERPREFERRED ONE
2130018102OTHERRAILROAD MEDICARE
3A011OTHERTRIWEST
4338516700MEDICAIDMINNESOTA
531Q17WAOTHERMINNESOTABLUE CROSS BLUE SHIELD
641-1677590OTHER1ST CHOICE OF THE MIDWEST
710088MEDICAIDNORTH DAKOTA
805-81578OTHERMEDICA
941-1677590OTHERWEA TRUST INSURANCE
10792831OTHERAMERICAS PPO
11C86943MEDICARE UPIN
12HP7170OTHERHEALTHPARTNERS
13130000795MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.