William Wagner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

032380 Issued in NY

Practice address

5141 Broadway
New York, NY 10034-1159

Phone

(212) 932-4000

NPI assigned

Jul 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Columbia Doctors of New Jersey P CGroup PAC ID 3375674138, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: cup9007@direct.nyp.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Columbia Doctors of New Jersey, P. C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ridgewood, NJ
  • NPI 1144459991
  Medicare reassignment Care Compare group NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488

  Physician Assistant

  NPD
• Columbia Doctors of New Jersey, P. C.

  • Orthopaedic Surgery Physician
  • Englewood, NJ
  • NPI 1184202822
  NPD
• Trustees of Columbia University in the Department of Otolaryngology

  • Specialist
  • New York, NY
  • NPI 1801074315
  NPD (past)

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1407684400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FRANKLIN AVE APT 6O",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106013857",
            "telephone_number": "845-554-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341159",
            "telephone_number": "212-932-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "693 White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "10709",
            "country_code": "US",
            "telephone_number": "212-305-4565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076314967",
            "country_code": "US",
            "telephone_number": "212-305-4565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032380",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Wagner, CRNA
• Sarah L Wagner
• Scott Timothy Wagner
• Stephanie Lynn Wagner, BSN, RNC, IBCLC, RLC
• Vanessa Wagner, PSY. D.
• Shara Wagowski
• Sharyn Heather Wagreich, D.C.
• Keith Wagstaff, LMSW
• Michelle Wah
• Romina Mariam Ma Wing Shan Wahab, M.D.

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.