Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Rex Dwayne Waggoner Jr., MD

Individual provider Family Medicine Physician · NPI 1588981435

Dr. Rex Dwayne Waggoner Jr., MD is a Family Practice in New York, New York. Qualified in 2010, 16 years ago. Practices with City Medical of Upper East Side PLLC, a 663-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2010
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

138 Delancey St
New York, NY 10002-3325
Phone: (212) 609-2541
Fax: (212) 609-2542
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7425 Grand Ave, Elmhurst, NY 11373-4126 — (718) 803-2273

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 272098 (NY)

Record details

NPI number1588981435
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 30, 2010
Last updated in NPPESNovember 7, 2019

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice City Medical Of Upper East Side Pllc — 663 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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