DR. DOUGLAS JEROME WAFFEN (M.D.) – Emergency Medicine Physician, NPI 1609858794
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,673 EMERGENCY MEDICINE in OH
Provider Addresses for DR. DOUGLAS JEROME WAFFEN (M.D.)
405 W Grand Ave
Dayton, OH 454057538
Phone: (937) 723-3211
Type: Location
Tripler Army Medical Center, 1, Jarrett White Road, Moanalua Gardens, Honolulu, Honolulu County, Hawaii, 96859, United States
TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
TRIPLER AMC, HI 968595001
Phone: (808) 433-2460
Fax: (808) 433-1558
Type: Mailing
100 Kettering Way
Franklin, OH 450051155
Phone: (937) 458-4700
Type: Location
4000 Miamisburg Centerville Rd
Miamisburg, OH 453427615
Phone: (937) 384-8791
Type: Location
3535 Southern Blvd
Kettering, OH 454291221
Phone: (937) 395-8166
Type: Location
1141 N Monroe Dr
Xenia, OH 453851619
Phone: (937) 352-2500
Type: Location
1997 Miamisburg Centerville Rd
Centerville, OH 454593811
Phone: (937) 401-6228
Type: Location
450 Washington Jackson Rd
Eaton, OH 453208699
Phone: (937) 456-8376
Type: Location
6147 State Route 122
Middletown, OH 450055201
Phone: (513) 261-3410
Type: Location
3535 Pentagon Blvd
Beavercreek, OH 454311705
Phone: (937) 702-4500
Type: Location
8701 Old Troy Pike
Huber Heights, OH 454241066
Phone: (937) 558-3338
Type: Location
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: 2019-07-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060320000271 | I | Emergency Medicine | HI | TBD |
| I20190709000801 | I | Emergency Medicine | IN | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45405)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | PA | |
| Emergency Medicine | HI | |
| Emergency Medicine | NC | |
| Emergency Medicine | MD | |
| Nurse Practitioner | HI | |
| Emergency Medicine | CE | |
| Emergency Medicine | HI | |
| Emergency Medicine | NC | |
| Emergency Medicine | TX | |
| Emergency Medicine | HI |
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