Individual provider Active NPI

Lee S Wagmeister, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Newburgh, IN
National Provider Identifier
1063470649
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
01052501A Issued in IN
Practice address
4015 Gateway Blvd
Suite 2120
Newburgh, IN 47630-8925
Phone
(812) 842-0907
Fax
(812) 464-0536
NPI assigned
May 3, 2006
Last updated
May 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01052501A IN Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 36924 KY

Addresses

Primary practice location

4015 Gateway Blvd
Suite 2120
Newburgh, IN 47630-8925

Mailing address

4015 Gateway Blvd Ste 2120
Newburgh, IN 47630-8925
Phone (812) 492-5457

Other identifiers 7

IdentifierTypeStateIssuer
0000475621-01OtherWELBORN HEALTH PLANS
438544OtherHEALTHLINK
000000174053OtherANTHEM
330005278OtherIN RR MCR
832011POtherSIHO
200267590MedicaidIN
64024532MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070427000441 IN Practitioner - Thoracic SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Surgery 6305750597 Reassigns benefits to 1 organization
I20111227000501 KY Practitioner - Cardiac Surgery 6305750597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery, Cardiovascular Disease (Cardiology)
Education
University of Rochester School of Medicine and Dentistry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4007 Gateway Blvd
Suite 100
Newburgh, IN 47630-8947
Phone (812) 450-7899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
72.6
Promoting interoperability
100
Improvement activities
40
Cost
69.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)65
Pacemaker insertion or repair11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36924KYMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 1, 2018 Accepting new patients
Deaconess Specialty Physicians, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
Deaconess Specialty Physicians, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
Deaconess Specialty Physicians Inc CurrentSince Jun 1, 2018 Accepting new patients
Deaconess Specialty Physicians, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 1, 2018 Accepting new patients

Locations

520 Mary St
Ste 230
Evansville, IN 47710
Phone (812) 450-8600

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4007 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 842-0907

4015 Gateway Blvd
Ste 2120
Newburgh, IN 47630
Phone (812) 492-5457

1138 N Elm St
Henderson, KY 42420
Phone (270) 827-8811

2200 E Parrish Ave
Owensboro, KY 42303
Phone (270) 691-0059

2200 E Parrish Ave
Bldg A
Owensboro, KY 42303
Phone (270) 228-2811

Interoperability endpoints

  • Direct secure messaging: lwagmeister25577@direct.deaconess.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1063470649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD STE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308925",
            "telephone_number": "812-492-5457",
            "fax_number": "812-464-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD",
            "address_2": "SUITE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308925",
            "telephone_number": "812-842-0907",
            "fax_number": "812-464-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGMEISTER",
        "first_name": "LEE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01052501A",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "36924",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELBORN HEALTH PLANS",
            "identifier": "0000475621-01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "438544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000174053",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN RR MCR",
            "identifier": "330005278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "832011P",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200267590",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64024532",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.