Meredith Wall Wagner, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

58455 Issued in TN

Practice address

4 Smithfield St FL 11
Pittsburgh, PA 15222-2222

Phone

(412) 224-2336

NPI assigned

Apr 16, 2013

Last updated

Dec 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Meredith Lynn Wall Former name

Medicare fee-for-service enrollment

Enrolled in CA, TN, IL, MN, WI5 enrollments

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 5

Specialty

Dermatology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera MarshallGroup PAC ID 5799695227, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359
• Tamarack Health Ashland Medical Center Hospital, Ashland, WI, CCN 521359

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwagner@directaddress.net

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.

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Medicare reassignment Care Compare group NPD
• Dermatology East ,P.L.L.C.

  • Specialist
  • Germantown, TN
  • NPI 1043413891

  Dermatology

  Medicare reassignment NPD
• Dermatology Specialists Inc

  • Dermatology Physician
  • Oceanside, CA
  • NPI 1881631711
  Medicare reassignment NPD
• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989

  Dermatology

  Medicare reassignment NPD
• Telehealth Specialty Medical Group

  dba TeleMed2U

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment NPD
• Memorial Medical Center Inc

  dba Tamarack Health Ashland Medical Center

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment
• Avera Marshall

  dba Avera Medical Group Optometry - Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  dba Avera Medical Group Behavioral Health Services

  • Psychiatry Physician
  • Marshall, MN
  • NPI 1528293172
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Dermatologist on Call Medical Group PC

  dba DermatologistOnCall

  • Dermatology Physician
  • Latrobe, PA
  • NPI 1972048288
  NPD (past)
• Dermatology Specialists Inc

  • Dermatology Physician
  • San Marcos, CA
  • NPI 1578763876
  NPD (past)
• Dr. Adam T Keres LLC.

  • Chiropractor
  • Memphis, TN
  • NPI 1376738351
  NPD (past)

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

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Care Compare affiliation
• Memorial Medical Center Inc

  dba Tamarack Health Ashland Medical Center

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Care Compare affiliation

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1316380694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38567",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381830567",
            "telephone_number": "760-472-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SMITHFIELD ST FL 11",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152222222",
            "telephone_number": "412-224-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MEREDITH",
        "middle_name": "WALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "MD.48544",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A146514",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "58455",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.165930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "WALL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Thomas Wagner, DPM
• Julie M. Wagner, PA-C
• Justine Wagner
• Lauren Elizabeth Wagner, M.S., BCBA, LBS
• Mackenzie Nicole Wagner
• Patrick L Wagner, MD
• Rachel Marie Wagner, MSED, LPC, CAADC
• Melissa Ann Wagoner
• Wags With Mags PGH, LLC
• Caitlin Wahal, MS

• Dermatology Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.