NPIMap

Individual provider Active NPI

Eric R Wagner, MD

  • Orthopaedic Hand Surgery Physician
  • Atlanta, GA
National Provider Identifier
1619263241
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
081317 Issued in GA
Practice address
59 Executive Park S Ste 2000
Atlanta, GA 30329-2208
Phone
(404) 778-7249
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 081317 GA Primary
Orthopaedic Surgery Physician 207X00000X 269905 MA
Orthopaedic Surgery Physician 207X00000X 55500 MN

Addresses

Primary practice location

59 Executive Park S Ste 2000
Atlanta, GA 30329-2208

Mailing address

59 Executive Park S Ste 2000
Atlanta, GA 30329-2208
Phone (404) 778-7249

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003001989 GA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 9638326168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

655 Molly LN
Woodstock, GA 30189-6519
Phone (770) 517-1080

875 Flat Shoals Rd SE
Conyers, GA 30094-6640
Phone (770) 785-7669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Sep 18, 2018 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 18, 2018 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 18, 2018 Accepting new patients
Emory Health Care Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

59 Executive Park South NE
Ste 2000
Atlanta, GA 30329
Phone (404) 778-3347

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Interoperability endpoints

  • Direct secure messaging: ewagner57009@direct.emory.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1619263241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S STE 2000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S STE 2000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "GA",
            "license": "081317",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "269905",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "55500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.