Elizabeth Wagoner, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11014158 Issued in FL

Practice address

3375 Burns Rd Ste 101
Palm Beach Gardens, FL 33410-4360

Phone

(561) 622-3618

Fax

(561) 626-9822

NPI assigned

Jul 27, 2021

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tenet Florida Physician Services LLCGroup PAC ID 0345349478, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: elizabeth.wagoner.1@13023.direct.athenahealth.com

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.

• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  Medicare reassignment Care Compare group NPD
• Tenet Florida Physician Services, LLC

  • Physical Therapist
  • West Palm Beach, FL
  • NPI 1699111211
  NPD

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

• Palm Beach Gardens Community Hospital, Inc.

  dba Palm Beach Gardens Medical Center

  • General Acute Care Hospital
  • Palm Beach Gardens, FL
  • NPI 1144251216
  Care Compare affiliation

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1740953660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20800",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154105",
            "telephone_number": "888-402-7256",
            "fax_number": "888-902-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 BURNS RD STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104360",
            "telephone_number": "561-622-3618",
            "fax_number": "561-626-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thai Vuong
• Aleeyah Wade-Lester
• Arnot Q Wadsworth IV, P.T.
• Carmenza Wagner, LMT
• Laura Wagner
• Carol Watson Waldenburg, LMHC
• Ellie Rose Wale
• Walgreen Co (Walgreens Specialty Pharmacy #13451)
• Walgreen Co (Walgreens #09044)
• Walgreen Co (Walgreens #10576)

• Family Nurse Practitioner in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.