Ernestine A Wagner, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1289-23 Issued in WI

Practice address

2417 Post Road
Building a
Stevens Point, WI 54481

Phone

(715) 690-1272

Fax

(715) 544-1212

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

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

Merit-based Incentive Payment System (MIPS)

Final score

35.83 of 100Reported as group

Quality

9.6

Promoting interoperability

0

Improvement activities

0

Cost

76.51

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cary J Kohlenberg MD SC

  • Psychiatry Physician
  • Waukesha, WI
  • NPI 1952487506
  Medicare reassignment
• Ernestine Wagner, PA, Inc

  • Physician Assistant
  • North Tazewell, VA
  • NPI 1184860074
  NPD (past) Authorized official
• Bluefield Emergency Physicians Inc

  • Emergency Medicine Physician
  • Bluefield, WV
  • NPI 1073627089

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1124072889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 POST ROAD BUILDING A",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-690-1272",
            "fax_number": "715-544-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 POST ROAD",
            "address_2": "BUILDING A",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-690-1272",
            "fax_number": "715-544-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ERNESTINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1289-23",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "978",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001577",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001836169",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET",
            "identifier": "3001613",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10319951",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hien T Vo-Hill, MD
• Melady Vue
• Umesh Kumar Vyas, M.D.
• Natalie Wachowiak, LCSW
• Mark S. Wadina, M.D.
• Gail T. Wagner, NP
• Laura Wahn, BCBA
• Jessica Emily Waid, AUD
• Gerald Stephen Walczak, D.D.S.
• Walgreen Co

• Medical Physician Assistant in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.