Individual provider Active NPI

Michael Anthony Wagner, D.O.

  • Orthopaedic Surgery Physician
  • Clinton Township, MI
National Provider Identifier
1225349665
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101018806 Issued in MI
Practice address
38525 Hilldale St
Clinton Township, MI 48036-2564
Phone
(586) 469-8300
Fax
(586) 496-8115
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101018806 MI Primary

Addresses

Primary practice location

38525 Hilldale St
Clinton Township, MI 48036-2564

Mailing address

38525 Hilldale St
Clinton Township, MI 48036-2564
Phone (248) 635-6104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160927001850 MI Practitioner - Orthopedic Surgery 5890014583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

36500 S Gratiot Ave
102 Multispecialties
Clinton Township, MI 48035-1772
Phone (586) 790-9003

38525 Hilldale St
Clinton Township, MI 48036-2564
Phone (586) 469-8300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement26
Knee replacement29
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a Wagner PLLC Orthopaedic Surgery CurrentSince Sep 1, 2016 Accepting new patients
McLaren Macomb Family Medicine CurrentSince Oct 1, 2016 Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

21620 Harrington St
Clinton Twp, MI 48036
Phone (586) 469-8300

38525 Hilldale St
Clinton Twp, MI 48036
Phone (586) 469-8300

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

Organizations & group practices 2

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 4

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1225349665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38525 HILLDALE ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362564",
            "telephone_number": "248-635-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38525 HILLDALE ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362564",
            "telephone_number": "586-469-8300",
            "fax_number": "586-496-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101018806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.