Willis H. Wagner, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G049464 Issued in CA

Practice address

8631 W 3Rd St
Suite 615E
Los Angeles, CA 90048-5901

Phone

(310) 652-8132

Fax

(310) 659-3815

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Vascular Surgery

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vascular Surgery AssociatesGroup PAC ID 3072984129, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
• Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score

93.23 of 100Reported as group

Quality

77.83

Promoting interoperability

98

Improvement activities

40

Cost

71.17

Merit-based Incentive Payment System (MIPS)

Final score

92.16 of 100Reported as group

Quality

71.79

Promoting interoperability

100

Improvement activities

40

Cost

68.75

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: wwagner91844@direct.cshs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vascular Surgery Associates

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1538871686
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Medicare reassignment
• Vascular Surgery Associates

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1154341691
  Medicare reassignment
• Kidney Transplant Associates

  • Transplant Surgery Physician
  • Los Angeles, CA
  • NPI 1417036203
  NPD (past)
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Care Compare affiliation
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • West Hollywood, CA
  • NPI 1891940326
  Care Compare affiliation
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191801600000",
    "number": "1003836248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 615E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-652-8132",
            "fax_number": "310-659-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 615E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-652-8132",
            "fax_number": "310-659-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILLIS",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G049464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan L. Wagner, PH.D.
• Sarah Wagner, MOT
• Talessa Nicole Wagner
• Talia Mays Wagner, L.M.F.T.
• Taylor Alana Wagner
• Jimesha Wagoner
• Eric Wagreich, MD
• Kasey Wagstaffe
• May Let Wah
• Nazo Wahab, PSY.D.

• Vascular Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.