Individual provider Active NPI

Jamie Lynn Wagner, D.O.

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1154534733
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M3784 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4009
Phone
(713) 792-6161
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M3784 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4009

Mailing address

P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other identifiers 1

IdentifierTypeStateIssuer
192038104MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20130507000324 KS Practitioner - Surgical OncologyPractitioner - General Surgery 2163517848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

10710 Nall Ave
Overland Park, KS 66211-1206
Phone (913) 588-1227

10720 Nall Ave
Overland Park, KS 66211-1206

10790 Nall Ave
Overland Park, KS 66211-1206
Phone (913) 588-1227

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

2650 Shawnee Mission Pkwy
Westwood, KS 66205-2003

3901 Rainbow Blvd
Kansas City, KS 66160-7330
Phone (913) 588-6144

4000 Cambridge St
Suite G600
Kansas City, KS 66160-8501
Phone (913) 588-1227

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Merit-based Incentive Payment System (MIPS)

Final score
24.74 of 100Reported as group
Quality
16.27
Promoting interoperability
0
Improvement activities
0
Cost
66.19

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy72
Melanoma (skin cancer) excision39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Surgery CurrentSince May 1, 2013 Accepting new patients
Kansas University Physicians Inc CurrentSince May 1, 2013 Accepting new patients
Kansas University Physicians Inc Surgery Current Accepting new patients
Olathe Health Physicians, Inc. Surgery Current Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

15123 S Omc Pkwy
Olathe, KS 66061
Phone (913) 355-8000

20805 W 151st St
Ste 400
Olathe, KS 66061
Phone (913) 355-4900

10710 Nall Ave
Overland Park, KS 66211
Phone (913) 588-9700

Interoperability endpoints

  • Direct secure messaging: jwagner178271@direct.kuha.org

Organizations & group practices 5

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 3

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1154534733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304009",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M3784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192038104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.