Active NPI
David K. Wagner, M.D.
- Emergency Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G62145
- Practice address
- 1401 S Grand Ave
Emergency Department
Los Angeles, CA 90015-3010 - Phone
- (213) 748-2411
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G62145 | CA | Primary |
Addresses
Primary practice location
1401 S Grand Ave
Emergency Department
Los Angeles, CA 90015-3010
Mailing address
2100 Powell St
Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G62145 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Cep America-California | Emergency Medicine | Current | Accepting new patients |
| Atlantic Coast Gastroenterology Associates | Past | Accepting new patients | |
| Allied Digestive Health, LLC | Past | Accepting new patients |
Locations
751 Medical Center Ct
#1182
Chula Vista, CA 91911
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- San Francisco, CA
- NPI 1023063542
-
- Emergency Medicine Physician
- Riverside, CA
- NPI 1386750578
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Gastroenterology Physician
- West Long Beach, NJ
- NPI 1265831259
-
- Gastroenterology Physician
- Brick, NJ
- NPI 1679512578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519862400000",
"number": "1326090556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST",
"address_2": "STE 900",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081844",
"telephone_number": "510-350-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 S GRAND AVE",
"address_2": "EMERGENCY DEPARTMENT",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153010",
"telephone_number": "213-748-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "DAVID",
"middle_name": "K.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2018-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G62145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.