NPIMap

Individual provider Active NPI

Jennifer Kathleen Wagner, M.D.

  • Orthopaedic Hand Surgery Physician
  • Santa Fe, NM
National Provider Identifier
1356504674
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD2022-0186 Issued in NM
Practice address
2968 Rodeo Park Dr W Ste 150
Santa Fe, NM 87505-6383
Phone
(505) 913-5227
NPI assigned
Jul 7, 2008
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X MD2022-0186 NM Primary

Addresses

Primary practice location

2968 Rodeo Park Dr W Ste 150
Santa Fe, NM 87505-6383

Mailing address

2968 Rodeo Park Dr W Ste 150
Santa Fe, NM 87505-6383
Phone (505) 913-5227

Other identifiers 1

IdentifierTypeStateIssuer
59076356MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725002989 NM Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 7810131455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

2968 Rodeo Park Dr W
150 Christus St Vincent
Santa Fe, NM 87505-6351
Phone (505) 982-5014

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)53
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2022-0186NMMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Aug 1, 2022 Accepting new patients
St. Vincent Hospital Orthopaedic Surgery CurrentSince Aug 1, 2022 Accepting new patients
St Vincent Hospital Current Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

2968 Rodeo Park Dr W
Ste 150
Santa Fe, NM 87505
Phone (505) 982-5014

1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

Interoperability endpoints

  • Direct secure messaging: jwagner287932@christushealth.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1356504674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 RODEO PARK DR W STE 150",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056383",
            "telephone_number": "505-913-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 RODEO PARK DR W STE 150",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056383",
            "telephone_number": "505-913-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NM",
            "license": "MD2022-0186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59076356",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.