NPIMap

Individual provider Active NPI

Andrew Standish Wagner, MD

  • Obstetrics & Gynecology Physician
  • Midland, MI
National Provider Identifier
1194703793
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301076172 Issued in MI
Practice address
4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126
Phone
(989) 837-9400
Fax
(989) 792-9860
NPI assigned
Jan 4, 2006
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301076172 MI Primary

Addresses

Primary practice location

4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126

Mailing address

5400 Mackinaw Rd
Suite 6100
Saginaw, MI 48604-9515
Phone (989) 792-3100

Other identifiers 2

IdentifierTypeStateIssuer
10 4203718MedicaidMI
P105248OtherBLUE CARE NETWORK ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000095 MI Practitioner - Obstetrics/Gynecology 0042104648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4401 Campus Ridge Dr
Suite Ll110
Midland, MI 48640-6126
Phone (989) 837-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Womens OB GYN PC Obstetrics & Gynecology CurrentSince Jul 12, 2000 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Sep 17, 2024 Accepting new patients
McLaren Flint Obstetrics & Gynecology CurrentSince Mar 9, 2025 Accepting new patients
McLaren Flint CurrentSince Mar 9, 2025 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Sep 17, 2024 Accepting new patients
Guy M Boike, MD PC PastSince Apr 1, 2003 Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients

Locations

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4401 N Campus Ridge Dr
Ste LL110
Midland, MI 48640
Phone (989) 837-9400

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

5400 Mackinaw Rd
Ste 6100
Saginaw, MI 48604
Phone (989) 792-3100

Interoperability endpoints

  • Direct secure messaging: andrewwagner@wobgyn.allscriptsdirect.net
  • Direct secure messaging: awagner162777@mymichiganhealth.midirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1194703793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW RD",
            "address_2": "SUITE 6100",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049515",
            "telephone_number": "989-792-3100",
            "fax_number": "989-792-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE LL110",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406126",
            "telephone_number": "989-837-9400",
            "fax_number": "989-792-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANDREW",
        "middle_name": "STANDISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301076172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10 4203718",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK ID #",
            "identifier": "P105248",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.