Individual provider Active NPI

Daniel B. Wagner, D.O.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1750348314
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
M6450 Issued in TX
Practice address
2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone
(817) 529-1900
Fax
(817) 529-1910
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X M6450 TX
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X M6450 TX Primary

Addresses

Primary practice location

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124

Mailing address

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone (817) 529-1900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070731000233 TX Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5597763052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Kansas City University of Physicians and Surgeons, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael H Boothby, MD, PAGroup PAC ID 0446426134, 12 clinicians
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone 81752919002010

350 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 717-5390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.11 of 100Reported as group
Quality
55.05
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Merit-based Incentive Payment System (MIPS)

Final score
71.67 of 100Reported as individual
Quality
37.63
Promoting interoperability
100
Improvement activities
40
Cost
67.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement37
Knee replacement61
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6450TXMDAdult Reconstructive Orthopaedic Surgery Physician
3554AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michael H Boothby, MD PA Orthopaedic Surgery CurrentSince Oct 1, 2024 Accepting new patients
Institute for Bone and Joint Disorders PC Orthopaedic Surgery Past Accepting new patients

Locations

2901 Acme Brick Plz
Ft Worth, TX 76109
Phone (817) 423-2329

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 5

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1750348314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DANIEL",
        "middle_name": "B.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "M6450",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "TX",
            "license": "M6450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.