Individual provider Active NPI

Thanh H Duong Wagner, MD

  • Cardiovascular Disease Physician
  • West Palm Beach, FL
National Provider Identifier
1720088230
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME77423 Issued in FL
Practice address
1411 N Flagler Dr Ste 8000
West Palm Beach, FL 33401-3413
Phone
(561) 655-1318
Fax
(561) 655-6623
NPI assigned
Jul 26, 2005
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME77423 FL Primary
Cardiovascular Disease Physician 207RC0000X 22999 WI

Addresses

Primary practice location

1411 N Flagler Dr Ste 8000
West Palm Beach, FL 33401-3413

Mailing address

1411 N Flagler Dr Ste 8000
West Palm Beach, FL 33401-3413
Phone (561) 655-1318

Other practice location 1

1717 N E St
Suite 331
Pensacola, FL 32501
Phone (850) 484-6500

Other practice location 2

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-8900

Other identifiers 2

IdentifierTypeStateIssuer
2594315 00MedicaidFL
009926650MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100826000984 FL Practitioner - Cardiovascular Disease (Cardiology) 5991887143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Wisconsin School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

185 Banyan Blvd
FL 2
West Palm Beach, FL 33401-4644
Phone (305) 243-6704

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.03 of 100Reported as subgroup
Quality
88.14
Promoting interoperability
100
Improvement activities
40
Cost
65.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME77423FLMDCardiovascular Disease Physician
22999WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Apr 17, 2023 Accepting new patients
Tenet Florida Physician Services LLC Cardiovascular Disease CurrentSince Sep 30, 2018 Accepting new patients
Tenet Florida Physician Services, LLC CurrentSince Sep 30, 2018 Accepting new patients
University of Miami Cardiovascular Disease CurrentSince Apr 17, 2023 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tduongwagner122961@direct.med.miami.edu

Organizations & group practices 5

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.

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1720088230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 8000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013413",
            "telephone_number": "561-655-1318",
            "fax_number": "850-857-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 8000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013413",
            "telephone_number": "561-655-1318",
            "fax_number": "561-655-6623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 N E St",
            "address_2": "Suite 331",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "32501",
            "country_code": "US",
            "telephone_number": "850-484-6500",
            "fax_number": "850-857-1747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG WAGNER",
        "first_name": "THANH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME77423",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "22999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2594315 00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009926650",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.