Individual provider Active NPI

Jason Michael Wagner, MD

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
National Provider Identifier
1972594471
Registry record updated Apr 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
24510 Issued in OK
Practice address
940 NE 13TH St
Suite 4G4250
Oklahoma City, OK 73104-5008
Phone
(405) 271-5125
Fax
(405) 271-3462
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 24510 OK Primary

Addresses

Primary practice location

940 NE 13TH St
Suite 4G4250
Oklahoma City, OK 73104-5008

Mailing address

940 NE 13TH St
Suite 4G4250
Oklahoma City, OK 73104-5008
Phone (405) 271-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20101102000973 OK Practitioner - Diagnostic Radiology 9739238775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Missouri, Columbia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1000 NE 13TH St
Oklahoma City, OK 73104-5040
Phone (405) 271-3445

105 S Bryant Ave
Suite 404 Ou Health Physicians
Edmond, OK 73034-6331
Phone (405) 271-2663

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-2669

14101 N Eastern Ave
Ou Health Physicians
Edmond, OK 73013-5859
Phone (572) 244-0202

711 Stanton L Young Blvd
Oklahoma City, OK 73104-5023
Phone (405) 271-4700

800 NE 10TH St
Ouhp Stephenson Cancer Center
Oklahoma City, OK 73104-5418
Phone (405) 271-1112

825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Duncan Regional Hospital, Inc Hospital, Duncan, OK, CCN 370023
  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24510OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 18, 2010 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 18, 2010 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

940 NE 13th St
#4G4250
Oklahoma City, OK 73104
Phone (405) 271-1654

940 NE 13th St
Ste 4G4250
Oklahoma City, OK 73104
Phone (405) 271-5125

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

940 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-2429

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: jwagner17450@ouhealth.direct-ci.net

Organizations & group practices 5

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272067200000",
    "number": "1972594471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "address_2": "SUITE 4G4250",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-5125",
            "fax_number": "405-271-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "address_2": "SUITE 4G4250",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-5125",
            "fax_number": "405-271-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "24510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.