Daniel Jason Wagner, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

L8997 Issued in TX

Practice address

13526 Peseta CT
Corpus Christi, TX 78418-6932

Phone

(361) 949-0354

Fax

(361) 985-5147

NPI assigned

Sep 20, 2006

Last updated

Jun 15, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Emergency Medicine

Education

University of Texas Medical Branch at Galveston, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

T L C Medical Centers, LLCGroup PAC ID 1759566565, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• T L C Medical Centers, LLC

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1508174939
  Medicare reassignment Care Compare group
• Bayside Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Corpus Christi, TX
  • NPI 1902831241
  NPD (past)
• Bayside Emergency Pyhsicians, LLP

  • Emergency Medicine Physician
  • Beeville, TX
  • NPI 1174558324
  NPD (past)
• Sparkling Sea Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Corpus Christi, TX
  • NPI 1467549014
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1700983582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13526 PESETA CT",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186932",
            "telephone_number": "361-949-0354",
            "fax_number": "361-985-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13526 PESETA CT",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186932",
            "telephone_number": "361-949-0354",
            "fax_number": "361-985-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DANIEL",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L8997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175143002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175143001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darria Alexandria Wade
• Sabrina Marie Wadhams
• Monica Jenae Wadsworth
• Kacy Lamar Wagne, PHARM.D.
• Anna Wagner, FNP
• Matthew Wagner, DO
• Kimberly Rae Wahl, PHARMD,BCACP
• Eric Wait, M.D.
• Wal-Mart Stores Texas LLC (Wal-Mart Pharmacy 10-0464)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0490)

• Emergency Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.