Active NPI
Richard Wagner, PA-C
- Physician Assistant
- Tulsa, OK
National Provider Identifier
1326405879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2606
- Practice address
- 2325 S Harvard Ave
Tulsa, OK 74114 - Phone
- (918) 712-4301
- Fax
- (918) 560-1399
- NPI assigned
- Jan 27, 2016
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2606 | OK | Primary |
Addresses
Primary practice location
2325 S Harvard Ave
Tulsa, OK 74114
Mailing address
2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 587-9471
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 3
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.
-
dba F&CS
- Community/Behavioral Health Agency
- Tulsa, OK
- NPI 1023122439
-
- Health Service Clinic/Center
- Tulsa, OK
- NPI 1720427784
-
dba Access Medical Center
- Urgent Care Clinic/Center
- Edmond, OK
- NPI 1104056365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1326405879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 S HARVARD AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741143300",
"telephone_number": "918-712-4301",
"fax_number": "918-560-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2325 S HARVARD AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "74114",
"telephone_number": "918-712-4301",
"fax_number": "918-560-1399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "RICHARD",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-27",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "2606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.