Individual provider Active NPI

Gebhard Wagener, M.D.

  • Critical Care Medicine (Anesthesiology) Physician
  • New York, NY
National Provider Identifier
1942354212
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
260505 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 305-9878
Fax
(212) 305-8980
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 260505 NY
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 260505 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101220000929 NY Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 6204024151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Critical Care (Intensivists)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001711NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Anesthesiology CurrentSince Nov 1, 1996 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Anesthesiology CurrentSince Aug 1, 2018 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#C
New York, NY 10032
Phone (212) 305-8710

622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: wagener@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

Hospital & facility affiliations 5

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1942354212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENER",
        "first_name": "GEBHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "260505",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NY",
            "license": "260505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.