Monica Wagner

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

28224168A Issued in IN

Practice address

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Phone

(317) 338-7780

NPI assigned

Oct 29, 2019

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: monica.deryckere.1@7598.direct.athenahealth.com

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375
  Medicare reassignment Care Compare group
• St Vincent Medical Group Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1558686436
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1154965531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401257",
            "telephone_number": "317-650-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "28224168A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey David Wagner, MD
• John F Wagner, MD
• Karyn Elizabeth Wagner
• Keelie Madison Wagner, APRN, CPNP-PC
• Megan Theresa Wagner
• Patrick A Wagner, PHD
• Samantha Louise Wagner, M.D.
• Susan Elaine Wagner, DDS
• Whitney Wagner, NP-C
• Yen T Wagner, DDS

• Gerontology Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
• 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.