Daniel Leroy Waggoner, MD is a medicare enrolled "Allergy & Immunology" physician in Mystic, Connecticut. He went to University Of South Alabama College Of Medicine and graduated in 2001 and has 24 years of diverse experience with area of expertise as Allergy/immunology. He is a member of the group practice Shoreline Allergy And Asthma Associates Llp and his current practice location is
23 Clara Dr, Suite 204, Mystic, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 536-2995.
Daniel Leroy Waggoner is licensed to practice in Connecticut (license number 045087) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1558406066.
Physician's Profile
| Full Name | Daniel Leroy Waggoner |
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| Gender | Male |
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| Speciality | Allergy/immunology |
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| Experience | 24 Years |
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| Location | 23 Clara Dr, Mystic, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Daniel Leroy Waggoner attended and graduated from University Of South Alabama College Of Medicine in 2001
NPI Data:
- NPI Number: 1558406066
- Provider Enumeration Date: 02/21/2007
- Last Update Date: 03/25/2016
Medicare PECOS Information:
- PECOS PAC ID: 1254431349
- Enrollment ID: I20070702000358
Medical Identifiers
Medical identifiers for Daniel Leroy Waggoner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558406066 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207K00000X | Allergy & Immunology | 045087 (Connecticut) | Primary |
| 207KA0200X | Allergy & Immunology - Allergy | 45087 (Connecticut) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Shoreline Allergy And Asthma Associates Llp | 9739157819 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Daniel Leroy Waggoner allows following entities to bill medicare on his behalf.
| Entity Name | Shoreline Allergy & Asthma Associates Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881757243
PECOS PAC ID: 9739157819
Enrollment ID: O20040917000539 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Daniel Leroy Waggoner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Daniel Leroy Waggoner, MD
23 Clara Dr, Suite 204,
Mystic, CT 06355-1959
Ph: (860) 536-2995 | Daniel Leroy Waggoner, MD
23 Clara Dr, Suite 204,
Mystic, CT 06355-1959
Ph: (860) 536-2995 |
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