NPIMap

Individual provider Active NPI

Troy D Wagner

  • Surgical Physician Assistant
  • Billings, MT
National Provider Identifier
1790732204
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MED-PAC-LIC-442 Issued in MT
Practice address
2900 12TH Ave N
Suite 140W
Billings, MT 59101-7506
Phone
(406) 238-6540
Fax
(406) 238-6599
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 442 MT
Surgical Physician Assistant 363AS0400X MED-PAC-LIC-442 MT Primary

Addresses

Primary practice location

2900 12TH Ave N
Suite 140W
Billings, MT 59101-7506

Mailing address

PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500

Other identifiers 2

IdentifierTypeStateIssuer
4307970MedicaidMT
000900323OtherMTBCBS PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060310000483 MT Practitioner - Physician Assistant 1456309442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2702 8TH Ave N
Billings, MT 59101-1107
Phone (406) 238-5254

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

2929 10TH Ave N
Billings, MT 59101-0721
Phone (406) 657-4000

801 N 29TH St
Billings, MT 59101-0905
Phone (406) 238-2500

Hospital & facility affiliations

  • Billings Clinic Hospital Hospital, Billings, MT, CCN 270004
  • Beartooth Billings Clinic Hospital, Red Lodge, MT, CCN 271326
  • Stillwater Billings Clinic Hospital, Columbus, MT, CCN 271330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
442MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Aug 13, 2007 Accepting new patients
Billings Clinic CurrentSince Aug 13, 2007 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
University of Virginia Physicians Group Past Accepting new patients

Locations

2702 8th Ave N
Billings, MT 59101
Phone (406) 238-2769

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

1202 3rd St W
Roundup, MT 59072
Phone (406) 323-2301

Interoperability endpoints

  • Direct secure messaging: twagner@billingsclinic.cernerdirect.com

Organizations & group practices 5

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 10

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1790732204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100",
            "telephone_number": "406-238-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 140W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6540",
            "fax_number": "406-238-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TROY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "442",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "MED-PAC-LIC-442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4307970",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "000900323",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.