Individual provider Active NPI

Andrew Wagner, CRNA

  • Certified Registered Nurse Anesthetist
  • Fresno, CA
National Provider Identifier
1861978819
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
779455 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 459-4349
NPI assigned
Jul 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 779455 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

2311 E Trenton Ave
Fresno, CA 93720-3927
Phone (559) 321-3441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190131001779 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800133620 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

805 W Acequia Ave
Suite 2D
Visalia, CA 93291-6164
Phone (559) 320-0530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Nov 6, 2018 Accepting new patients
Comprehensive Anesthesia, a California Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2020 Accepting new patients
Community Health Partners CurrentSince Aug 14, 2021 Accepting new patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Community Foundation Medical Group CurrentSince Nov 6, 2018 Accepting new patients
Evexia Wellness Centers Inc Nurse Anesthetist, Certified Registered PastSince Nov 15, 2020 Accepting new patients

Locations

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1332 W Herndon Ave
Ste 102
Fresno, CA 93711
Phone (559) 440-9640

7417 N Cedar Ave
Ste 101
Fresno, CA 93720
Phone (559) 437-5645

1843 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 323-6611

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

15 E Audubon Dr
Fresno, CA 93720
Phone (559) 433-8000

7417 N Cedar Ave
Fresno, CA 93720
Phone 5594360871111

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 6

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 1

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1861978819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 E TRENTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203927",
            "telephone_number": "559-321-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "779455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.