Danielle Taylor Wagner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

315 S Manning Blvd
Medical Imaging Department
Albany, NY 12208-1707

Phone

(518) 525-1852

NPI assigned

Jun 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Danielle Williams Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwagner789425@direct.trinity-health.org

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.

• St. Peter's Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Physician Assistant

  Medicare reassignment NPD
• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1588013288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "MEDICAL IMAGING DEPARTMENT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DANIELLE",
        "middle_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04548225",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "address_2": "Medical Imaging Department",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "WILLIAMS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mariah Taylor Waaland, PA-C
• Nadine Wacksman, OTR/L
• Kristen Wade
• Kristie L Wade, CRNA
• Nancy Wade, MD
• Hannah Wagner, PA-C
• Mark H. Wagner, PH.D.
• Asina Wahab
• Gabrielle Waibel, OTR/L
• Jordan Paige Waite, MS, CAS

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.