NPIMap

Individual provider Active NPI

Richard Otto Wagner, MD

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1194752683
Registry record updated Mar 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
19448-020 Issued in WI
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Jun 28, 2006
Last updated
Mar 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 19448-020 WI Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040329001695 WI Practitioner - Diagnostic Radiology 7719899863 Reassigns benefits to 9 organizations
I20250603002599 MN Practitioner - Diagnostic Radiology 7719899863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Donalsonville Hospital IncGroup PAC ID 7113919820, 63 clinicians
Fred Smeltzer MD and Associates IncGroup PAC ID 8921078304, 95 clinicians

Practice addresses (Care Compare)

Germantown, WI 53022
Phone (615) 312-0600

7770 S Cross Cut TRL
Woodruff, WI 54568-9668
Phone (404) 662-2438

N116W17866 Blackstone Cir
Germantown, WI 53022-5665
Phone (607) 547-3456

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.32 of 100Reported as group
Quality
91.68
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.24 of 100Reported as group
Quality
100
Improvement activities
40
Cost
84.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41504TNMDPharmacist
19448WIMDFamily Medicine Physician
19448-020WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Jun 10, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jul 3, 2023 Accepting new patients
Memphis Physicians Radiological Group PC Diagnostic Radiology CurrentSince Jul 2, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jul 3, 2023 Accepting new patients
Lakewood Health System Current Accepting new patients
Fred Smeltzer MD & Associates Inc Diagnostic Radiology CurrentSince Mar 1, 2024 Accepting new patients
United Memorial Medical Center CurrentSince Jul 8, 2023 Accepting new patients
Donalsonville Hospital Inc CurrentSince Dec 15, 2018 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Apr 1, 2018 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Jul 18, 2016 Accepting new patients
Comprehensive Breast Care Center of Texas, Inc Past Accepting new patients
Sanford Clinic Diagnostic Radiology Past Accepting new patients
Wisconsin Radiology Specialists, S C Past Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Diagnostic Radiology Past Accepting new patients
Medical Scanning Consultants, P.a. Diagnostic Radiology Past Accepting new patients
Comprehensive Breast Care Center of Texas Inc Diagnostic Radiology Past Accepting new patients
Ozarks Medical Center Diagnostic Radiology Past Accepting new patients
Breast Diagnostic Clinic SC Diagnostic Radiology Past Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

807 S Isabella St
Sylvester, GA 31791
Phone (229) 777-3851

10 Little Brook Rd
West Wareham, MA 02576

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

7200 Cathedral Rock Dr
Ste 230
Las Vegas, NV 89128
Phone (702) 623-7568

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 7

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774051200000",
    "number": "1194752683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "middle_name": "OTTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "19448-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.