Active NPI
Jordan Wagner, D.O.
- Emergency Medicine Physician
- Cambridge, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20A14140
- Practice address
- 1493 Cambridge St
Cambridge, MA 02139-1047 - Phone
- (617) 665-1435
- NPI assigned
- Jul 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 249402 | MA | |
| Emergency Medicine Physician | 207P00000X | 20A14140 | CA | Primary |
Addresses
Primary practice location
1493 Cambridge St
Cambridge, MA 02139-1047
Mailing address
1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of New England, College of Osteo Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cep America - California
Practice addresses (Care Compare)
1141 Rose Ave
Selma, CA 93662-3241
Phone (559) 891-1000
1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A14140 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palomar Emergency Physicians, Inc | Emergency Medicine | Current | Accepting new patients |
| Montclair Emergency Medical Associates | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Alvarado Emergency Medical Associates, Inc. | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
Locations
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111
15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000
1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000
6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130
1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- San Diego, CA
- NPI 1285811992
-
- Emergency Medicine Physician
- Montclair, CA
- NPI 1316044696
-
- Emergency Medicine Physician
- Escondido, CA
- NPI 1124698139
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chula Vista, CA
- NPI 1396728630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1558590679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391047",
"telephone_number": "617-665-1435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391047",
"telephone_number": "617-665-1435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JORDAN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-10",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "249402",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A14140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.