Benjamin Paul Wagner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A208292 Issued in CA

Practice address

4256 Hacienda Dr Ste 100
Pleasanton, CA 94588-8595

Phone

(925) 264-6510

Fax

(925) 263-0251

NPI assigned

Apr 2, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Pediatric Medicine

Education

University of Kentucky College of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• University Healthcare Alliance

  • Internal Medicine Physician
  • Newark, CA
  • NPI 1760531198
  NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1568924231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 HACIENDA DR STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888595",
            "telephone_number": "925-264-6510",
            "fax_number": "925-263-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4256 HACIENDA DR STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888595",
            "telephone_number": "925-264-6510",
            "fax_number": "925-263-0251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Jackson Avenue",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-3066",
            "fax_number": "253-968-0384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BENJAMIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A208292",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61339518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Voravong
• Chandana Vundavalli
• Aditi Vyas
• Bharati M Vyas
• Harsh Wadhwa, MD
• Megan Wahl, MS, ATC, CSCS
• Jessica Wakeman, LAC
• Michael Waldman
• Walgreen Co
• Walgreen Co

• Pediatrics Physician in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.