Matthew Ryan Wagner

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWB-2022-0777 Issued in NM

Practice address

6601 Valentine Way
Santa Fe, NM 87507-7301

Phone

(505) 988-1951

NPI assigned

Jun 13, 2022

Last updated

Jan 2, 2025By the provider in NPPES

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 NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Green Cliff Counseling, LLC

  • Clinical Social Worker
  • Santa Fe, NM
  • NPI 1285502203
  Medicare reassignment NPD Authorized official
• Solace Crisis Treatment Center

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1558435719
  NPD (past)
• Solace Crisis Treatment Center

  • Case Management Agency
  • Santa Fe, NM
  • NPI 1912339714
  NPD (past)

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1053041137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 VALENTINE WAY",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875077301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 VALENTINE WAY",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875077301",
            "telephone_number": "505-988-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vuelta Health, LLC
• Emily Catherine Wabick, PA-C
• Gretchen Wachs, LPCC
• Carlyn Wade
• Jennifer Kathleen Wagner, M.D.
• Michael J. Wagner
• Wagreens Pharmacy
• Robin Wakeland
• Waking Sky Psychiatry LLC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0829)

• Clinical Social Worker in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.