Matthew John Wagner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

344001-01 Issued in NY

Practice address

535 W 110TH St Apt 1E
New York, NY 10025-2021

Phone

(212) 280-4740

Fax

(212) 280-4743

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1841982709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252021",
            "telephone_number": "212-280-4740",
            "fax_number": "212-280-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252021",
            "telephone_number": "212-280-4740",
            "fax_number": "212-280-4743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 3rd St",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073022611",
            "country_code": "US",
            "telephone_number": "212-280-4740",
            "fax_number": "212-280-4743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "344001-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Wagner, MS,CCC
• Lisa Wagner, NP
• Lucy Wagner
• Lynda Jeanne Wagner
• Madlen Wagner
• Meredith A Wagner, M.D
• Michael Wagner, MD
• Nicole Elizabeth Wagner, MD
• Philip J Wagner, M.D.
• Robert Wagner, CRNA

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.