Rebecca Wagner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1581 Austin Hwy Ste 102
San Antonio, TX 78218-1860

Phone

(210) 436-8400

Fax

(833) 452-1052

NPI assigned

Nov 22, 2016

Last updated

Jan 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Care

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Clinic - Broken Bow

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1134662299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 AUSTIN HWY STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782181860",
            "telephone_number": "210-436-8400",
            "fax_number": "833-452-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 AUSTIN HWY STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782181860",
            "telephone_number": "210-436-8400",
            "fax_number": "833-452-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "REBECCA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2023-01-27",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.wagner.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "1581 Austin Hwy Ste 102",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782181860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gail Wagner
• Hannah Wagner
• Jill Wagner
• Kailan Wagner
• Kathryn A Wagner, M.D.
• Sara Elida Wagner, CCC-SLP
• Sydney J Wagner, LPC-A
• Timothy Downey Wagner, MD, MBA
• Cassandra Wagoner, PT, DPT
• Kailyn Michele Wagoner

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.