Individual provider Active NPI

Rebecca Wagner Michaels, PA-C

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1053720490
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9121186 Issued in FL
Practice address
6535 Nemours Pkwy
Orlando, FL 32827-7884
Phone
(407) 650-7000
Fax
(407) 567-5924
NPI assigned
Aug 11, 2014
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-11827 NC
Surgical Physician Assistant 363AS0400X PA9121186 FL Primary
Physician Assistant 363A00000X 0110006278 VA

Addresses

Primary practice location

6535 Nemours Pkwy
Orlando, FL 32827-7884

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100

Other practice location 1

2301 Erwin Road
Durham, NC 27710-1910
Phone (919) 681-2343

Other names 1

  • Rebecca L Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011000189 NC Practitioner - Physician Assistant 8527280759 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017826NYMDSpecialist
0010-11827NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Aug 28, 2023 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

Interoperability endpoints

  • Direct secure messaging: rwagner506252@direct.medicine.duke.edu

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1053720490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277884",
            "telephone_number": "407-650-7000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Road",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277101910",
            "country_code": "US",
            "telephone_number": "919-681-2343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "REBECCA",
        "middle_name": "WAGNER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-11827",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9121186",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WAGNER",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.