Individual provider Active NPI

Ross Garrett Wagner, M.D.

  • Anesthesiology Physician
  • Vancouver, WA
National Provider Identifier
1659608883
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60337701 Issued in WA
Practice address
505 NE 87TH Ave
Suite 46.5
Vancouver, WA 98664-1989
Phone
(360) 828-5396
Fax
(360) 828-5455
NPI assigned
Nov 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD60337701 WA Primary

Addresses

Primary practice location

505 NE 87TH Ave
Suite 46.5
Vancouver, WA 98664-1989

Mailing address

505 NE 87TH Ave
Suite 46.5
Vancouver, WA 98664-1989
Phone (360) 828-5396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20130723000771 WA Practitioner - Anesthesiology 7517103526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Colorado School of Medicine, Denver, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians
Columbia Anesthesia Group P SGroup PAC ID 8426954322, 71 clinicians

Practice addresses (Care Compare)

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000

400 NE Mother Joseph Place
Vancouver, WA 98664-3200
Phone (360) 256-2000

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Merit-based Incentive Payment System (MIPS)

Final score
73.51 of 100Reported as group
Quality
68.84
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60337701WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Dec 20, 2023 Accepting new patients

Locations

7300 SW Childs Rd
Ste A
Tigard, OR 97224
Phone (360) 828-5396

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 2

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": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1659608883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE",
            "address_2": "SUITE 46.5",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641989",
            "telephone_number": "360-828-5396",
            "fax_number": "360-828-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE",
            "address_2": "SUITE 46.5",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641989",
            "telephone_number": "360-828-5396",
            "fax_number": "360-828-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ROSS",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-09",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60337701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.