Beth Ellen Wagner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

032.0095970 Issued in VT

Practice address

130 Fisher Rd
Hospitalist Program
Berlin, VT 05602-9516

Phone

(802) 225-1743

Fax

(802) 225-1745

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

Family Practice

Education

University of New England, College of Osteo Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Vermont Medical Center IncGroup PAC ID 9335138817, shared by 4 NPIs, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Central Vermont Medical Center Hospital, Barre, VT, CCN 470001
• Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwagner107036@direct.uvmhealth.org

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.

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784
  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  • Internal Medicine Physician
  • Berlin, VT
  • NPI 1831374362

  Family Medicine

  Medicare reassignment NPD

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

• Central Vermont Medical Center Inc

  • General Acute Care Hospital
  • Berlin, VT
  • NPI 1508845637
  Care Compare affiliation
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  Care Compare affiliation

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1871720482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-225-1743",
            "fax_number": "802-225-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "address_2": "HOSPITALIST PROGRAM",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-225-1743",
            "fax_number": "802-225-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BETH",
        "middle_name": "ELLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "5247",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "032.0095970",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VT",
            "license": "032.0095970",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022074",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0914",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University of Vermont Medical Center Inc
• Roberta Updegrove, M.A.
• John Valentine, MD
• Julie A Vogel, MD
• Deborah S Wachtel, N.P.
• Wal-Mart Stores East LP
• Washington County Mental Health Services, Inc.
• Washington County Mental Health Services, Inc.
• Washington County Mental Health Services, Inc.
• Washington County Mental Health Services, Inc.

• Family Medicine Physician in Berlin, VT
• Providers in Berlin, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.