NPIMap

Individual provider Active NPI

Philip J Wagner, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1831134964
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
206778 Issued in NY
Practice address
535 E 70TH St
HSS Dept. of Anesthesiology
New York, NY 10021-4823
Phone
(212) 774-2383
Fax
(212) 774-7808
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 206778 NY Primary

Addresses

Primary practice location

535 E 70TH St
HSS Dept. of Anesthesiology
New York, NY 10021-4823

Mailing address

Gpo Box 27578
New York, NY 10087-7578
Phone (844) 268-4820

Other identifiers 4

IdentifierTypeStateIssuer
ME139303OtherFLSTATE LICENSE
01914910MedicaidNY
206778OtherNYSTATE LICENSE
33977OtherCTSTATE LICENSE

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address pwagner5582@direct.HSS.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20050727000820 NY Practitioner - Anesthesiology 5193753598 Reassigns benefits to 1 organization
I20201203000813 FL Practitioner - Anesthesiology 5193753598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Rochester School of Medicine and Dentistry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East River Medical Associates PCGroup PAC ID 1052207479, 116 clinicians

Practice addresses (Care Compare)

535 E 70TH St
New York, NY 10021-4823
Phone (212) 606-1206

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206778NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East River Medical Associates P.C. Anesthesiology CurrentSince Feb 6, 1998 Accepting new patients
Orthopedic Anesthesia Pain Specialists Florida PA Anesthesiology CurrentSince Aug 14, 2020 Accepting new patients

Locations

300 Palm Beach Lakes Blvd
West Palm Beach, FL 33401
Phone (561) 657-4600

90 Merrick Ave
East Meadow, NY 11554
Phone (212) 606-1206

1233 2nd Ave
New York, NY 10065
Phone (212) 548-2900

535 E 70th St
New York, NY 10021

610 W 58th St
New York, NY 10019
Phone (212) 774-2474

Interoperability endpoints

  • Direct secure messaging: pwagner5582@direct.hss.edu

Organizations & group practices 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1831134964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GPO BOX 27578",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877578",
            "telephone_number": "844-268-4820",
            "fax_number": "631-201-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "address_2": "HSS DEPT. OF ANESTHESIOLOGY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-774-2383",
            "fax_number": "212-774-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PHILIP",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "206778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME139303",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01914910",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "206778",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "33977",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwagner5582@direct.HSS.edu",
            "affiliation": "N",
            "endpointDescription": "Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "address_2": "HSS Dept. of Anesthesiology",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "address_2": "HSS Dept. of Anesthesiology",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "address_2": "HSS Dept. of Anesthesiology",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.