Mitchell Wagner, MD

Primary specialty

Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X

License

27272 Issued in AZ

Practice address

520 Rose LN
Wickenburg, AZ 85390-1447

Phone

(928) 684-4365

Fax

(928) 684-2434

NPI assigned

Oct 17, 2006

Last updated

Feb 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Orthopedic Surgery

Education

University of New Mexico School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Hospital Association IncGroup PAC ID 4981688900, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wickenburg Community Hospital Hospital, Wickenburg, AZ, CCN 031300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Hospital Association, Inc.

  dba Wickenburg Community Hospital

  • Critical Access Hospital
  • Wickenburg, AZ
  • NPI 1841282852
  Medicare reassignment Care Compare group NPD
• Community Hospital Association, Inc.

  • Rehabilitation Clinic/Center
  • Bagdad, AZ
  • NPI 1730445347
  NPD
• Center for Orthopedic Research and Education, LLC

  dba The CORE Institute

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1427095801
  NPD (past)
• Community Hospital Association, Inc.

  dba Community Hospital Clinic - Wickenburg

  • Rural Health Clinic/Center
  • Wickenburg, AZ
  • NPI 1225274210
  NPD (past)

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

• Community Hospital Association, Inc.

  dba Wickenburg Community Hospital

  • Critical Access Hospital
  • Wickenburg, AZ
  • NPI 1841282852
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1447330741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "928-684-4365",
            "fax_number": "928-684-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "928-684-4365",
            "fax_number": "928-684-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "27272",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "AZ",
            "license": "27272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "457920",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0866130",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7878067",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Turning Point Mental Health, LLC
• TX Gold Inpatient Services, PLLC
• Juan Angel Vasquez, MD
• Vital Physicians PLLC
• Elizabeth Ann Wagner, BM, MT-BC
• Rebecca Suzanne Walpole, FNP
• Christoper Alan Warren, NRP, FP-C, CCP-C
• Conor Westerman, PMHNP
• Wickenburg Diabetes & Wound Care Center LLC
• Wickenburg Healthcare Alliance Inc (WHA Medical)

• Orthopaedic Trauma Physician in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Orthopaedic Trauma Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.