Hillary J Wagner, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

PENDING Issued in WA

Practice address

11234 Anderson St
Gme Office Westerly Suite 'C'
Loma Linda, CA 92354-2804

Phone

(909) 558-4289

NPI assigned

Apr 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, IL, WA3 enrollments

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 3

Specialty

Urology

Education

Loma Linda University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hwagner24413@direct.llu.edu
• Direct secure messaging: hwagner731911@direct.peacehealth.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.

• Peacehealth

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Peacehealth

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatric Cardiology Physician
  • Beaumont, CA
  • NPI 1871766121
  NPD
• Peacehealth

  • Physical Therapist
  • Longview, WA
  • NPI 1275501538
  NPD (past)

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

• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1437579570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE 'C'",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE 'C'",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 9th Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322465",
            "country_code": "US",
            "telephone_number": "360-636-8950",
            "fax_number": "360-636-8951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8614 E Mill Plain Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986642058",
            "country_code": "US",
            "telephone_number": "360-729-8580",
            "fax_number": "360-729-8599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HILLARY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diep Vuong, MD
• John Tuan Vy, DPT
• Nidia R Vyhmeister, MD
• Matthew Wade, MD
• Garrett Andrew Wagner, MD
• Robert Wagner, M.D.
• Andrew Walter Wai, M.D.
• Angela Gay Wakefield
• Andrew John Walayat
• Diana Jean Walayat, M.D.

• Urology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.