Michel Randolph Peter Wagner, MD

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

MD066014L Issued in PA

Practice address

2580 Haymaker Rd Ste 304
Monroeville, PA 15146-3500

Phone

(412) 858-3070

Fax

(412) 858-3076

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE, OK, PA, GA, MI, TX, DC, VA8 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 8

Specialty

General Surgery

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Specialty Associates PLLCGroup PAC ID 7618235995, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wmichel303728@direct.ahn.org
• Direct secure messaging: mwagner47197@achce.catholichealth.net
• Direct secure messaging: michel.wagner@hca5.eclinicaldirectplus.com

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.

• Urgent Specialty Associates PLLC

  • Surgery Physician
  • Richmond, VA
  • NPI 1487164604

  DC

  Medicare reassignment Care Compare group NPD
• Allegheny Clinic

  dba AHN-Primary Care Bethel Park

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment NPD
• Susquehanna Physician Services

  • Surgery Physician
  • Williamsport, PA
  • NPI 1881622868
  Medicare reassignment NPD
• Acute Care Surgery of South Dakota PC

  • Orthopaedic Surgery Physician
  • Rapid City, SD
  • NPI 1730797184

  OK, Surgical Critical Care

  Medicare reassignment NPD
• Acute Care Surgical Affiliates of Texas PA

  • Surgery Physician
  • Corpus Christi, TX
  • NPI 1407322415
  Medicare reassignment NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Surgery

  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Urgent Specialty Associates of Texas, PLLC

  • Surgical Critical Care Physician
  • Kingwood, TX
  • NPI 1790350445
  Medicare reassignment NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD

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

• Chippenham & Johnston-Willis Hospitals Inc

  dba CJW Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation
• Orange Park Medical Center, Inc.

  dba HCA Florida Orange Park Hospital

  • General Acute Care Hospital
  • Orange Park, FL
  • NPI 1689611501
  Care Compare affiliation

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1447200647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-3070",
            "fax_number": "412-858-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-3070",
            "fax_number": "412-858-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MICHEL",
        "middle_name": "RANDOLPH PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD066014L",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "PA",
            "license": "MD066014L",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD066014L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10614208",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wmichel303728@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2580 Haymaker Rd Ste 304",
            "city": "Monroeville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151463500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Vrana, LCSW
• Rebecca Ann Vrescak, CRNA
• Avni Patel Vyas, MD
• Emily E Wagner, CRNP
• Grace Wagner, PROFESSIONAL COUNSEL
• Elaine S Wahl, RDN
• Emily Wakeley, PA-C
• Tanya Walburn, LSW
• Mackenzie Waldran, PA
• David Waldron

• Surgical Critical Care Physician in Monroeville, PA
• Providers in Monroeville, PA by specialty
• Surgical Critical Care Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.