Individual provider Active NPI

Noel David Wagner, M.D.

  • Emergency Medicine Physician
  • Saginaw, MI
National Provider Identifier
1952374597
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301093040 Issued in MI
Practice address
900 Cooper Ave
Saginaw, MI 48602-5182
Phone
(989) 583-6521
Fax
(989) 583-4134
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301093040 MI Primary

Addresses

Primary practice location

900 Cooper Ave
Saginaw, MI 48602-5182

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-2833

Other identifiers 2

IdentifierTypeStateIssuer
162798602MedicaidTX
1952374597MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090119000024 MI Practitioner - Emergency Medicine 3274426838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

900 Cooper Ave
Saginaw, MI 48602-5182
Phone (989) 583-6521

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093040MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. Emergency Medicine CurrentSince Oct 1, 2008 Accepting new patients
Covenant Medical Center, Inc CurrentSince Oct 1, 2008 Accepting new patients
San Angelo Emergency Physicians Emergency Medicine Past Accepting new patients
East Texas Medical Center Healthcare Associates Emergency Medicine Past Accepting new patients
Valley Medical Facilities Inc Emergency Medicine Past Accepting new patients
Southwestern Emergency Physicians PC Emergency Medicine Past Accepting new patients

Locations

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

Interoperability endpoints

  • Direct secure messaging: nwagnermd1903@direct.covenanthealthcare.com

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1952374597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-2833",
            "fax_number": "989-583-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COOPER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025182",
            "telephone_number": "989-583-6521",
            "fax_number": "989-583-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NOEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301093040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162798602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952374597",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.