NPIMap

Individual provider Active NPI

Alexei Wagner, M.D.

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1750693891
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
283559 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 724-4100
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A125137 CA
Emergency Medicine Physician 207P00000X 283559 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

55 Fruit St
Boston, MA 02114-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130604000367 CA Practitioner - Emergency Medicine 7214173178 Reassigns benefits to 1 organization
I20201005001964 MA Practitioner - Emergency Medicine 7214173178 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125137CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Hospital Current Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Jan 1, 2022 Accepting new patients
The General Hospital Corporation CurrentSince Jan 13, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Emergency Medicine CurrentSince Jan 13, 2022 Accepting new patients
Brigham & Womens Physicians Organization Inc Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Oct 1, 2014 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Oct 1, 2014 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

75 Francis St
Boston, MA 02115

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

137 Stuart St
Ste A7
Boston, MA 02116
Phone (617) 393-5059

55 Fruit St
Boston, MA 02114

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: alexei.wagner@605326376828932.direct.elationemr.com
  • Direct secure messaging: wagner.alexei.bwh@direct.partners.masshiway.net

Organizations & group practices 10

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1750693891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ALEXEI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A125137",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "283559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.