Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jacob M Waidelich, MD

Individual provider Anesthesiology Physician · NPI 1194846998

Dr. Jacob M Waidelich, MD is an Anesthesiology in Fond Du Lac, Wisconsin. Graduated from University of Wisconsin School of Medicine in 2004, 22 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
22
Trained at
University of Wisconsin School of Medicine
Licensed in
WI
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

430 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 926-8340
Fax: (920) 926-8370
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 52040-20 (WI)

Record details

NPI number1194846998
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 2, 2007
Last updated in NPPESDecember 22, 2020
Certification dateDecember 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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