John Wager, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

23806 Issued in CA

Practice address

2485 Hospital Dr
Suite #351
Mountain View, CA 94040-4101

Phone

(650) 687-7322

Fax

(650) 988-7674

NPI assigned

May 28, 2007

Last updated

Nov 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• University of Rochester Physical Medicine and Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Rochester, NY
  • NPI 1649434648
  NPD (past)

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1417168642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 HOSPITAL DR",
            "address_2": "SUITE #351",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404101",
            "telephone_number": "650-687-7322",
            "fax_number": "650-988-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 HOSPITAL DR",
            "address_2": "SUITE #351",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404101",
            "telephone_number": "650-687-7322",
            "fax_number": "650-988-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGER",
        "first_name": "JOHN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-28",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "23806",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "23806",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "23806",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CA",
            "license": "23806",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "46-3467093",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smitha Vuyyuru, PA
• W. D. McCallum, M.D., Inc.
• Scott P Wachhorst, M.D.
• Selene Sophia Waddell, MC,LPC
• Shaira Wadhwani
• Bonny Jean Waggoner, FNP
• Alexander Wait
• Nicole Waitman, FNP
• Walgreen Co (Walgreens #13948)
• Walgreen Co (Walgreens #00689)

• Clinical Neuropsychologist in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.