Active NPI
Jamie Lynn Wagner, D.O.
- Surgery Physician
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- M3784
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 192038104 | Medicaid | TX |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Surgical Oncology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
- University of Kansas Health System Olathe Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 24.74 of 100
- Quality
- 16.27
- Promoting interoperability
- 0
- Improvement activities
- 0
- Cost
- 66.19
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.91 of 100
- Quality
- 77.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 72 |
| Melanoma (skin cancer) excision | 39 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas University Physicians Inc | Surgery | Current | Accepting new patients |
| Kansas University Physicians Inc | Current | 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
- 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.
-
- Cardiovascular Disease Physician
- Kansas City, KS
- NPI 1407637291
-
- Surgery Physician
- Kansas City, KS
- NPI 1508078890
-
- Internal Medicine Physician
- Kansas City, KS
- NPI 1699811521
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Olathe, KS
- NPI 1144266115
-
- General Acute Care Hospital
- Kansas City, KS
- NPI 1629369681
-
- General Acute Care Hospital
- Kansas City, KS
- NPI 1649259656
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.