Audrey Wagaman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

8326 Naab Rd
Indianapolis, IN 46260-1920

Phone

(317) 871-0000

Fax

(317) 871-0010

NPI assigned

May 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Hematology IncGroup PAC ID 8527406149, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audrey.wagaman.1@25782.direct.athenahealth.com

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.

• Innovative Hematology, Inc

  • Hematology & Oncology Physician
  • Indianapolis, IN
  • NPI 1881455541
  Medicare reassignment Care Compare group
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787
  Medicare reassignment NPD
• Indiana Hemophilia & Thrombosis Center, Inc.

  • Hematology & Oncology Physician
  • Indianapolis, IN
  • NPI 1659364800
  Medicare reassignment
• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment
• Indiana University Health Care Associates, Inc.

  • Registered Dietitian
  • Indianapolis, IN
  • NPI 1679949002
  NPD

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

• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1431820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1073991501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0011",
            "fax_number": "317-870-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0000",
            "fax_number": "317-871-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGAMAN",
        "first_name": "AUDREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-17",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teamnursing@ihtc.org",
            "affiliation": "N",
            "address_1": "8326 Naab Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney Leigh Wadsworth
• Kira Wadsworth, MSOT
• Michaela Wadsworth
• Tina Waegerle
• Nicole L Wafford, LPN
• Caroljean Wagener, MSW, LCSW, LCAC
• Gerardine Waggle, MSW,LCSW
• Amanda Waggoner
• Anna Elizabeth Waggoner, LMT
• Jacquelin K Waggoner, DNP

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.