Individual provider Active NPI

Robert Wagmeister, M.D.

  • Specialist
  • Santa Monica, CA
National Provider Identifier
1720014525
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G41624 Issued in CA
Practice address
2001 Santa Monica Blvd
Ste 670W
Santa Monica, CA 90404-2185
Phone
(310) 828-5626
Fax
(310) 828-2826
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G41624 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd
Ste 670W
Santa Monica, CA 90404-2185

Mailing address

2001 Santa Monica Blvd
Ste 670W
Santa Monica, CA 90404-2185
Phone (310) 828-5626

Other identifiers 1

IdentifierTypeStateIssuer
00G416240MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040826000977 CA Practitioner - Vascular Surgery 3274508056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Tufts University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 Santa Monica Blvd
Suite 670W
Santa Monica, CA 90404-2185
Phone (310) 828-5626

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion93
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41624CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rwagmeister53764@direct.uclahealth.org

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 3

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1720014525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "STE 670W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042185",
            "telephone_number": "310-828-5626",
            "fax_number": "310-828-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "STE 670W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042185",
            "telephone_number": "310-828-5626",
            "fax_number": "310-828-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGMEISTER",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G41624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G416240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.