NPIMap

Individual provider Active NPI

Lenard D Wagner, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lovington, NM
National Provider Identifier
1649216896
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
86-141 Issued in NM
Practice address
1600 North Main
Lovington, NM 88260-2813
Phone
(575) 396-6611
Fax
(575) 396-0318
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 86-141 NM Primary
General Practice Physician 208D00000X CS00009180 NM

Addresses

Primary practice location

1600 North Main
Lovington, NM 88260-2813

Mailing address

200 W Lea St
Hobbs, NM 88240-5110
Phone (575) 391-0270

Other identifiers 1

IdentifierTypeStateIssuer
36954MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20031208000593 NM Practitioner - Family Practice 0143126698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

1001 W Broadway
Suite D
Farmington, NM 87401-5638
Phone (505) 327-4796

1422 Paseo de Peralta
Santa Fe, NM 87501-4391
Phone (505) 982-5565

1501 10TH St
Alamogordo, NM 88310-5044
Phone (575) 434-2960

184 Unser Blvd NE
Rio Rancho, NM 87124-4045
Phone (505) 994-1640

835 Spruce St
Suite Candd
Espanola, NM 87532-3455
Phone (505) 747-7400

Hospital & facility affiliations

  • Excelacare Home Health Home health agency, Hobbs, NM, CCN 327100
  • Star Care Home Health Home health agency, Hobbs, NM, CCN 327189
  • Elite Home Health, LLC Home health agency, Hobbs, NM, CCN 327198
  • Family Hospice LTD Dba Gentiva Hospice, Hobbs, NM, CCN 321513
  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305
  • Covenant Health Hobbs Hospital Hospital, Hobbs, NM, CCN 320065
  • Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86-141NMMDGeriatric Medicine (Family Medicine) Physician
CS00009180NMMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Nov 18, 2013 Accepting new patients
Presbyterian Medical Services CurrentSince Nov 18, 2013 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Norte Vista Medical Arts LLC Past Accepting new patients
Presbyterian Medical Services Past Accepting new patients
Covenant Medical Group Past Accepting new patients
Covenant Medical Group Past Accepting new patients

Locations

200 W Lea St
Hobbs, NM 88240
Phone (505) 391-7477

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Interoperability endpoints

  • Direct secure messaging: lenard.wagner.p1@direct.pmsnm.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Excelacare Home HealthHobbs, NM, CCN 327100 Home health agency W-2 Managing Employee Jan 3, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1649216896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W LEA ST",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882405110",
            "telephone_number": "575-391-0270",
            "fax_number": "575-391-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 NORTH MAIN",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602813",
            "telephone_number": "575-396-6611",
            "fax_number": "575-396-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LENARD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "86-141",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "CS00009180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36954",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovington, NM

Sources for this page

Verify at the official NPI Registry.