ROXANNE CHRISTINE WAGGONER DO
NPI 1538788773
Student in an Organized Health Care Education/Training Program in Brooklyn, NY
About Roxanne Christine Waggoner Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROXANNE CHRISTINE WAGGONER DO (NPI 1538788773) is an individual student in an organized health care education/training program in Brooklyn, New York and active in the NPI registry since April 2020.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Roxanne Christine Waggoner Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Roxanne Waggoner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Brooklyn, NY 11219
- Reassigned Medicare billing, New York enrollment
- 1,177 clinicians in this Medicare group
Brooklyn, NY 11204
- Reassigned Medicare billing, New York enrollment
- 137 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BROOKLYN, NY 11219
BROOKLYN, NY 11219
BROOKLYN, NY 11219
BROOKLYN, NY 11219
BROOKLYN, NY 11219
BROOKLYN, NY 11219
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Roxanne Waggoner's NPI number?
The NPI number for Roxanne Waggoner is 1538788773. It was assigned to this individual provider in the NPPES registry on April 8, 2020.
Where is Roxanne Waggoner located?
Roxanne Waggoner practices at 4802 10th Ave, Brooklyn, NY 11219. The listed phone number is (575) 640-0062.
What is Roxanne Waggoner's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Roxanne Waggoner enrolled in Medicare?
Yes. Roxanne Waggoner is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Roxanne Waggoner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Roxanne Waggoner reassigns Medicare benefits to 2 organizations: Maimonides Faculty Practice Plan (Brooklyn, NY) and Mmc Pediatrics Faculty Practice (Brooklyn, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roxanne Waggoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Roxanne Waggoner was last updated on April 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Roxanne Christine Waggoner, DO · NPI 1538788773
Student in an Organized Health Care Education/Training Program provider in Brooklyn, New York. Individual provider, active in the CMS NPPES registry since April 8, 2020.
## Identity
- **NPI:** 1538788773 (Entity type: Individual)
- **Enumerated:** April 8, 2020
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4802 10TH AVE, Brooklyn, NY 11219-2916
- **Phone:** (575) 640-0062
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Maimonides Faculty Practice Plan (NPI 1053344846, Brooklyn, NY); Mmc Pediatrics Faculty Practice (NPI 1285648154, Brooklyn, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 8, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1538788773) · Data from the CMS NPPES public registry.