Individual provider Active NPI

Brian Wagstaff, MD

  • Family Medicine Physician
  • Key West, FL
National Provider Identifier
1639114499
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME92309 Issued in FL
Practice address
1501 Government Rd
Key West Urgent Care
Key West, FL 33040-5108
Phone
(305) 295-7550
Fax
(305) 296-3010
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME92309 FL Primary

Addresses

Primary practice location

1501 Government Rd
Key West Urgent Care
Key West, FL 33040-5108

Mailing address

1501 Government Rd
Key West Urgent Care
Key West, FL 33040-5108
Phone (305) 295-7550

Other identifiers 1

IdentifierTypeStateIssuer
ME92309OtherFLMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000960 FL Practitioner - Family PracticePractitioner - General Practice 4789626219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Columbia University College of Physicians and Surgeons, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1501 Government Rd
Key West, FL 33040-5108
Phone (305) 295-7550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Key West Urgent Care Inc CurrentSince Sep 1, 2015 Accepting new patients
University Family Medicine Association Family Medicine Past Accepting new patients
Mobile Medical Industries Inc Past Accepting new patients

Locations

1501 Government Rd
Key West, FL 33040
Phone (305) 293-7201

Organizations & group practices 3

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 4

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1639114499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 GOVERNMENT RD",
            "address_2": "KEY WEST URGENT CARE",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330405108",
            "telephone_number": "305-295-7550",
            "fax_number": "305-296-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 GOVERNMENT RD",
            "address_2": "KEY WEST URGENT CARE",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330405108",
            "telephone_number": "305-295-7550",
            "fax_number": "305-296-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTAFF",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME92309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "ME92309",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.