Individual provider Active NPI

Jason Kane Wagner, M.D.

  • Vascular Surgery Physician
  • Sarasota, FL
National Provider Identifier
1902168925
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME13985 Issued in FL
Practice address
600 N Cattlemen Rd Ste 220
Sarasota, FL 34232-6422
Phone
(941) 371-6565
NPI assigned
Jun 14, 2012
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME13985 FL Primary

Addresses

Primary practice location

600 N Cattlemen Rd Ste 220
Sarasota, FL 34232-6422

Mailing address

600 N Cattlemen Rd Ste 220
Sarasota, FL 34232-6422
Phone (941) 371-6565

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190612002652 FL Practitioner - Vascular Surgery 2466742655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Eastern Virginia Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Associates of SarasotaGroup PAC ID 3274431085, 15 clinicians

Practice addresses (Care Compare)

600 N Cattlemen Rd
Suite 220
Sarasota, FL 34232-6422
Phone (941) 371-6565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal64
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME13985FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Associates of Sarasota Vascular Surgery CurrentSince Jul 29, 2019 Accepting new patients

Locations

600 N Cattlemen Rd
Ste 220
Sarasota, FL 34232
Phone (941) 371-6565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1902168925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N CATTLEMEN RD STE 220",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326422",
            "telephone_number": "941-371-6565",
            "fax_number": "941-377-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N CATTLEMEN RD STE 220",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326422",
            "telephone_number": "941-371-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JASON",
        "middle_name": "KANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME13985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.