Brian Keith Wagner, D.P.M.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

000793 Issued in CT

Practice address

11 South Rd Lowr Level20
Farmington, CT 06032-2483

Phone

(860) 470-5703

Fax

(860) 606-8025

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Foot Specialists PCGroup PAC ID 7113920380, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Connecticut Foot Specialists, P.C.

  • Podiatrist
  • Farmington, CT
  • NPI 1487684346
  Medicare reassignment Care Compare group NPD Authorized official

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

• John Dempsey Hospital at Solnit - South Campus

  • Psychiatric Hospital Unit
  • Middletown, CT
  • NPI 1154263713
  Care Compare affiliation
• State of Connecticut

  • General Acute Care Hospital
  • Farmington, CT
  • NPI 1669466561
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1093743502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SOUTH ROAD",
            "address_2": "LOWER LEVEL 20",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-470-5703",
            "fax_number": "860-606-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SOUTH RD LOWR LEVEL20",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322483",
            "telephone_number": "860-470-5703",
            "fax_number": "860-606-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000793",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CT",
            "license": "000793",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000862",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "000793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay R Vose, DPT
• Glenna Elizabeth Voytovich, MA MFT
• Christina Vu, MD
• Vivian Vu, MD
• Rutvi Vyas, DDS
• Julie A. Wagner, PHD
• Richard Kent Wagner, MD
• Courtney Leigh Stead Wakefield, MD
• Shira L Wald
• Peter G Walden, M.D

• Foot Surgery Podiatrist in Farmington, CT
• Providers in Farmington, CT by specialty
• Foot Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.