NPIMap

Individual provider Active NPI

Kathryn R Wagner, MD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1043508617
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
269724 Issued in MA
Practice address
10 Belvidere Ave
Worcester, MA 01605
Phone
(952) 595-1100
Fax
(612) 294-4903
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 304543 LA
Diagnostic Radiology Physician 2085R0202X 269724 MA Primary

Addresses

Primary practice location

10 Belvidere Ave
Worcester, MA 01605

Mailing address

11995 Singletree LN
Ste 500
Eden Prairie, MN 55344-5347
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190503000998 CT Practitioner - Diagnostic Radiology 5092006486 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians
Midstate Radiology Associates LLCGroup PAC ID 4880593565, 89 clinicians
Meriden Imaging Center IncGroup PAC ID 4385683556, 56 clinicians

Practice addresses (Care Compare)

300 Kensington Ave
New Britain, CT 06051-3916
Phone (860) 258-3480

326 Washington St
Norwich, CT 06360-2740
Phone (203) 949-2700

863 N Main St Ext
Wallingford, CT 06492-2434

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
82.26
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
304543LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC CurrentSince May 16, 2025 Accepting new patients
Midstate Radiology Associates, LLC Diagnostic Radiology CurrentSince Apr 1, 2019 Accepting new patients
Diagnostic Imaging Services of CT, LLC Diagnostic Radiology CurrentSince Apr 1, 2019 Accepting new patients
Meriden Imaging Center, Inc. Diagnostic Radiology CurrentSince Apr 1, 2019 Accepting new patients
Starling Physicians PLLC CurrentSince May 16, 2025 Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

680 S Main St
Cheshire, CT 06410
Phone (203) 272-3595

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

300 Kensington Ave
New Britain, CT 06051
Phone (860) 224-6200

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1 Towne Park Plz
Norwich, CT 06360
Phone (860) 886-1433

863 N Main Street Ext
Wallingford, CT 06492

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

1260 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 258-3477

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1043508617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BELVIDERE AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHRYN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "304543",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "269724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.