NPIMap

Individual provider Active NPI

Patrick Nathan Wagner, M.D.

  • Anesthesiology Physician
  • Green Bay, WI
National Provider Identifier
1437320033
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
53625-20 Issued in WI
Practice address
835 S Van Buren St
Dept of Anesthesiology
Green Bay, WI 54301-3526
Phone
(920) 857-0894
NPI assigned
Mar 21, 2008
Last updated
Dec 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 53625-20 WI Primary

Addresses

Primary practice location

835 S Van Buren St
Dept of Anesthesiology
Green Bay, WI 54301-3526

Mailing address

835 S Van Buren St
P.O. Box 13508
Green Bay, WI 54301-3526
Phone (920) 857-0894

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwagner33127@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120628000609 WI Practitioner - Anesthesiology 8527223320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Bay Anesthesia Assoc. SCGroup PAC ID 4486613858, 70 clinicians

Practice addresses (Care Compare)

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 498-4200

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.22 of 100Reported as group
Quality
69.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53625-20WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Anesthesia Assoc. SC Anesthesiology CurrentSince Aug 1, 2012 Accepting new patients

Locations

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

Bin 88263
Milwaukee, WI 53288

Interoperability endpoints

  • Direct secure messaging: pwagner33127@ewd.direct.hshs.org

Organizations & group practices 1

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 6

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": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1437320033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "address_2": "P.O. BOX 13508",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-857-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-857-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PATRICK",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-21",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "53625-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwagner33127@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S Van Buren St",
            "address_2": "Dept of Anesthesiology",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.