Individual provider Active NPI

Anagha S Wagle, BSCOT

  • Specialist
  • Sebring, FL
National Provider Identifier
1770784647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT-4560 Issued in FL
Practice address
5959 Sun N Lake Blvd
Sebring, FL 33872-2075
Phone
(863) 471-6128
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT-4560 FL Primary

Addresses

Primary practice location

5959 Sun N Lake Blvd
Sebring, FL 33872-2075

Mailing address

4514 Bream Ave
Sebring, FL 33870-1012
Phone (863) 314-0214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107001279 FL Practitioner - Occupational Therapist in Private Practice 9234663618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-4560FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Next PT Group Florida, LLC CurrentSince Aug 19, 2024 Accepting new patients

Locations

901 Vista Trelago Way
Maitland, FL 32751
Phone (407) 388-4477

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770784647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 BREAM AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338701012",
            "telephone_number": "863-314-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722075",
            "telephone_number": "863-471-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGLE",
        "first_name": "ANAGHA",
        "middle_name": "S",
        "credential": "BSCOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OT-4560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.