Rebecca A Wagaman, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME49648 Issued in FL

Practice address

330 E Hibiscus Blvd
Melbourne, FL 32901-3155

Phone

(321) 724-2229

Fax

(321) 728-6668

NPI assigned

Sep 7, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Florida Department of Health

  • Public Health or Welfare Agency
  • Viera, FL
  • NPI 1386751907
  NPD (past)
• Hibiscus OB GYN Physicians P.a.

  • Obstetrics & Gynecology Physician
  • Melbourne, FL
  • NPI 1811942683
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1740274646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013155",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013155",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGAMAN",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME49648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046612300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristy Vonploennies
• Adrianne Vyasulu Leonhardt, LCSW
• W Robert Addington II DO LLC
• Allison Muia Wade, MD
• Travis Charles Wade, BS
• Donald C Wagner, M.D.
• Gisela L Wagner, MD
• Kathleen Mary Wagner, ARNP
• Kristin Wagner, P.A.
• William A Wahl, MD

• Obstetrics & Gynecology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.