Active NPI
Brice Wagner, PA-C
- Medical Physician Assistant
- Covington, LA
National Provider Identifier
1568037232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 20 Starbrush Cir
Covington, LA 70433-7208 - Phone
- (985) 231-5713
- NPI assigned
- May 25, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
20 Starbrush Cir
Covington, LA 70433-7208
Mailing address
20 Starbrush Cir
Covington, LA 70433-7208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1010 C M Fagan Dr
Suite 100
Hammond, LA 70403-6061
Phone (985) 777-7000
20 Starbrush Cir
Covington, LA 70433-7208
Phone (985) 777-7000
Hospital & facility affiliations
- St Tammany Parish Hospital
- North Oaks Medical Center
- Riverside Medical Center
- Ochsner Medical Center - Baton Rouge
- Ochsner Medical Center Acute
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- brice.wagner.1@20904.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Interventional Cardiology Physician
- Covington, LA
- NPI 1083187330
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baton Rouge, LA
- NPI 1053360651
-
- Rural Acute Care Hospital
- Hammond, LA
- NPI 1144227539
-
- General Acute Care Hospital
- New Orleans, LA
- NPI 1811973100
-
- Critical Access Hospital
- Franklinton, LA
- NPI 1700874062
-
- Internal Medicine Physician
- Covington, LA
- NPI 1083793582
Hospital
-
- Pulmonary Disease Physician
- Covington, LA
- NPI 1285285874
Hospital
-
- General Acute Care Hospital
- Covington, LA
- NPI 1598798597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1568037232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 STARBRUSH CIR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704337208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 STARBRUSH CIR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704337208",
"telephone_number": "985-231-5713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "BRICE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.