Matthew Roy Wagoner, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

612 Issued in NC

Practice address

2001 N Church St Ste 101
Greensboro, NC 27405-5633

Phone

(336) 375-6990

NPI assigned

Jul 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moses Cone Affiliated Physicians, Inc.Group PAC ID 3779635396, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwagoner200703@direct.conehealth.com

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.

• Moses Cone Affiliated Physicians, Inc

  • Obstetrics & Gynecology Physician
  • Greensboro, NC
  • NPI 1346474103
  Medicare reassignment Care Compare group NPD
• Moses Cone Affiliated Physicians, Inc.

  • Gynecology Physician
  • Greensboro, NC
  • NPI 1417610627
  NPD
• Moses Cone Affiliated Physicians, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Greensboro, NC
  • NPI 1952614620
  NPD

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1770870974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055633",
            "telephone_number": "336-375-6990",
            "fax_number": "336-375-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N CHURCH ST STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055633",
            "telephone_number": "336-375-6990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2706 Saint Jude St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274053670",
            "country_code": "US",
            "telephone_number": "336-375-6990",
            "fax_number": "336-375-0361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "MATTHEW",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006317",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwagoner200703@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "cone health direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2001 N Church St Ste 101",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274055633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bethany Ruth Wagler, DNP, AGPCNP-BC
• Jaime Stephan Wagner, D.O.
• Lorena Wagner
• Suzanne Wagner, MD
• Lynn Wagoner
• Robert A Wainer, MD
• Wake Forest Ambulatory Ventures, LLC
• Wake Forest Baptist Health
• Wake Forest Baptist Imaging LLC
• Wake Forest Emergency Providers

• Foot & Ankle Surgery Podiatrist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Foot & Ankle Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.