Individual provider Active NPI

John Bagnasco, M.D.

  • Obstetrics & Gynecology Physician
  • Waco, TX
National Provider Identifier
1114935483
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K5789 Issued in TX
Practice address
601 W Hwy 6
Ste 101
Waco, TX 76710-5591
Phone
(254) 772-5454
Fax
(254) 772-6464
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K5789 TX Primary

Addresses

Primary practice location

601 W Hwy 6
Ste 101
Waco, TX 76710-5591

Mailing address

PO Box 18962
Belfast, ME 04915-4084
Phone (800) 566-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071210000103 TX Practitioner - Obstetrics/Gynecology 9830288166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

601 W State Hwy 6 101
Waco Center for Womens Health
Waco, TX 76710-5592
Phone (254) 772-5454

Hospital & facility affiliations

  • Ascension Providence Hospital, Waco, TX, CCN 450042

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Oct 1, 2010 Accepting new patients
Providence Health Alliance CurrentSince Oct 1, 2010 Accepting new patients

Locations

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

601 W State Highway 6
Ste 101
Waco, TX 76710
Phone (254) 772-5454

405 Londonderry Dr
Ste 311
Waco, TX 76712
Phone (254) 235-4414

Interoperability endpoints

  • Direct secure messaging: john.bagnasco.1@9635.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1114935483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18962",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "800-566-5050",
            "fax_number": "254-772-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W HWY 6",
            "address_2": "STE 101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105591",
            "telephone_number": "254-772-5454",
            "fax_number": "254-772-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNASCO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K5789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.