BEAU E WADDELL (MD) – Family Medicine Physician, NPI 1053713636

BEAU E WADDELL (MD) is a healthcare provider. based in Hawarden, Iowa. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 62893-20 (WI). The NPI Number for BEAU E WADDELL (MD) is 1053713636

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
BEAU E WADDELL (MD)
NPI
1053713636
Phone
(712) 551-3100
Address
1111 11TH ST
Enumeration Date
25 September 2014
Last Update Date
18 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6087567100
Graduation Year
2012 (14 years ago)
PAC ID
9830413913
Group Practice PAC ID
7416860440
Professional Enrollment ID
I20150120001516
Address ID
WI535461626JA3524XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,656 FAMILY PRACTICE in IA

Provider Addresses for BEAU E WADDELL (MD)

  • 1111 11TH ST

    HAWARDEN, IA 510231903

    Phone: (712) 551-3100

    Fax: (712) 551-3177

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150120001516IFamily PracticeWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes827369$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit281281$0
99213Established patient office or other outpatient visit, 20-29 minutes6861$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only4140$0
99495Transitional care management services for problem of at least moderate complexity3831$0
View full utilization report →

Insurance plans in this area (ZIP 51023)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416860440View full group profile

Reviews

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Frequently asked questions

Is BEAU E WADDELL (MD) listed with a National Provider Identifier?
Yes — BEAU E WADDELL (MD) has NPI 1053713636 on file in the registry.
Would BEAU E WADDELL (MD) appear as active to a payer?
You can treat BEAU E WADDELL (MD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe BEAU E WADDELL (MD)'s focus?
For BEAU E WADDELL (MD), the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is BEAU E WADDELL (MD) located near Hawarden?
BEAU E WADDELL (MD) currently maps to Hawarden, Iowa in this extract.
Does BEAU E WADDELL (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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