Michael D Wagner, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

81-335 Issued in NM

Practice address

1010 Spruce St 3Rd FL Area 5
Espanola, NM 87532-2724

Phone

(505) 367-0340

Fax

(505) 747-2025

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Pulmonary DiseaseAlso: Internal Medicine

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Espanola Hospital Hospital, Espanola, NM, CCN 320011
• Holy Cross Hospital a Div of Taos Health Systems Hospital, Taos, NM, CCN 321310

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwagner77412@direct.phs.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.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Presbyterian Healthcare Services

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

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

• Presbyterian Healthcare Services

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  Care Compare affiliation
• Taos Health Systems Inc Holy Cross Hospital

  • General Acute Care Hospital
  • Taos, NM
  • NPI 1194751958
  Care Compare affiliation
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1043217797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SPRUCE ST STE B",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875323455",
            "telephone_number": "505-753-7499",
            "fax_number": "505-753-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST 3RD FL AREA 5",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "505-367-0340",
            "fax_number": "505-747-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "81335",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NM",
            "license": "81-335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33308",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica L Vigil, LMT
• Zachary Vigil
• Laurie L Vigne, RN, CDE
• Alexander Thomas Vining, PA-C
• Visionwest, Inc.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Valerie Lynn Wall, FNP-C
• Rebecca Jane Wallig, DO

• Pulmonary Disease Physician in Espanola, NM
• Providers in Espanola, NM by specialty
• Pulmonary Disease Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.