Thomas Wagner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34007204 Issued in OH

Practice address

34960 Center Ridge Rd
N Ridgeville, OH 44039-3183

Phone

(440) 353-3433

Fax

(440) 353-3431

NPI assigned

Aug 16, 2005

Sex

Male

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
• Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
• University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
• Uh St John Medical Center Hospital, Westlake, OH, CCN 360123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twagner21057@ehrdirect.uhhospitals.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.

• University Primary Care Practices Inc

  • Gastroenterology Physician
  • Mentor, OH
  • NPI 1003935339
  Medicare reassignment Care Compare group NPD
• University Primary Care Practices Inc

  • Family Medicine Physician
  • Jefferson, OH
  • NPI 1588795322
  NPD
• University Primary Care Practices Inc

  • Orthopaedic Surgery Physician
  • Oberlin, OH
  • NPI 1982727087
  NPD
• University Primary Care Practices

  • Pediatrics Physician
  • Twinsburg, OH
  • NPI 1326166752
  NPD (past)
• Westshore Primary Care Assoc Inc

  • Family Medicine Physician
  • Avon Lake, OH
  • NPI 1295842284
  NPD (past)

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

• Emh Regional Medical Center

  • General Acute Care Hospital
  • Elyria, OH
  • NPI 1841299039
  Care Compare affiliation
• University Hospitals Cleveland Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1043397292
  Care Compare affiliation
• University Hospitals Cleveland Medical Center

  • Multi-Specialty Clinic/Center
  • Mentor, OH
  • NPI 1487770335

  Hospital

  Care Compare affiliation
• University Hospitals Cleveland Medical Center

  • Multi-Specialty Clinic/Center
  • Westlake, OH
  • NPI 1669598082

  Hospital

  Care Compare affiliation
• University Hospitals Home Care Services Inc

  • Home Health Agency
  • Warrensville Heights, OH
  • NPI 1417940826
  Care Compare affiliation
• University Hospitals of Cleveland

  • Clinic/Center
  • Cleveland, OH
  • NPI 1760673412

  Hospital

  Care Compare affiliation
• University Hospitals St. John Medical Center

  • General Acute Care Hospital
  • Westlake, OH
  • NPI 1841264868
  Care Compare affiliation

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1669464673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34960 CENTER RIDGE RD",
            "city": "N RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393183",
            "telephone_number": "440-353-3433",
            "fax_number": "440-353-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00103662",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2253832",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomaswagner@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "32800 Lorain Rd Ste 2100",
            "city": "North Ridgeville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440393430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabriella Palma, MD
• Douglas J Potoczak, MD
• Pyramed Healthcare Group, LTD
• Karen Swanson, CNP
• Temple Transportation LLC

• Family Medicine Physician in N Ridgeville, OH
• Providers in N Ridgeville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.