Individual provider Active NPI

Priya Tahiliani Wagner, M.D.

  • Pediatrics Physician
  • Annapolis, MD
National Provider Identifier
1912963554
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0061797 Issued in MD
Practice address
200 Forbes St
#200
Annapolis, MD 21401-1538
Phone
(410) 263-6363
Fax
(410) 263-7551
NPI assigned
Apr 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0061797 MD Primary

Addresses

Primary practice location

200 Forbes St
#200
Annapolis, MD 21401-1538

Mailing address

8730 Little Patuxent CT
Odenton, MD 21113-2797
Phone (301) 912-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060921000366 MA Practitioner - Pediatric Medicine 4880699073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
State University of New York at Buffalo School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1177 Providence Hwy
Route 1
Norwood, MA 02062
Phone (781) 329-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061797MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince May 15, 2018 Accepting new patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince May 15, 2018 Accepting new patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

1 Lyons St
Dedham, MA 02026
Phone (781) 278-5511

Interoperability endpoints

  • Direct secure messaging: pwagnermd17448@direct.atrius.masshiway.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912963554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 LITTLE PATUXENT CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132797",
            "telephone_number": "301-912-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORBES ST",
            "address_2": "#200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011538",
            "telephone_number": "410-263-6363",
            "fax_number": "410-263-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PRIYA",
        "middle_name": "TAHILIANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0061797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.