Michael Donald Wagner, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

23008 Issued in OK

Practice address

750 NE 13TH St
Ste. 200
Oklahoma City, OK 73104-5051

Phone

(405) 271-4351

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Anesthesiology

Education

University of Arkansas College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Viera Hospital Hospital, Melbourne, FL, CCN 100315
• Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwagner69546@epicdirect.hf.org

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.

• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  Medicare reassignment Care Compare group NPD
• University of Oklahoma College of Medicine

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1497039044

  Anesthesiology

  NPD (past)
• Brevard Anesthesia Services PA

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1699881664
  NPD (past)
• The Stingl Family Foundation, Inc

  • Clinic/Center
  • Melbourne, FL
  • NPI 1548629108
  NPD (past)

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

• Holmes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Palm Bay, FL
  • NPI 1386940823
  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376682716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 STANTON L YOUNG BLVD",
            "address_2": "BMSB 357",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NE 13TH ST",
            "address_2": "STE. 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045051",
            "telephone_number": "405-271-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MICHAEL",
        "middle_name": "DONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "23008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack C Wagner
• Janelle Wagner, APRN
• Jason Michael Wagner, MD
• Leslie Dawn Wagner
• Mariah Nicole Wagner, DPT
• Veronica Wagner, LPN
• Tammy L Wagstaff, APRN-CNP
• Gennifer Wahbah Makhoul, M.D.
• Gauri S Waingankar, MD
• David B Waisel, MD

• Anesthesiology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.