DR. ANDREW WAGNER NPI 1215317888

NPI Information

NPI: 1215317888
Provider Name: DR. ANDREW WAGNER
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
52 W UNDERWOOD ST
ORLANDO, FL
ZIP 32806
Phone: (321) 842-8475
Get Directions

DR. Andrew Wagner is a vascular and interventional radiology radiology in Orlando, FL with 9 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. DR. Andrew Wagner NPI is 1215317888. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: FLORIDA ATLANTIC UNIVERSITY, COLLEGE OF MEDICINE
Graduation Year:2015

The provider's business location address is:

52 W UNDERWOOD ST
ORLANDO, FL
ZIP 32806-110
Phone: (321) 842-8475

The NPI 1215317888 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/8/2015 and was last updated on 3/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	266705	MASSACHUSETTS	No
2	2085R0204X	Radiology	Vascular & Interventional Radiology	2020015515	MISSOURI	No
3	208600000X	Surgery		125067171	ILLINOIS	No
4	2085R0204X	Radiology	Vascular & Interventional Radiology	ME149963	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110602800	MEDICAID	FLORIDA
2	EKE7E	OTHER	FLORIDA	BCBS
3	PS630	OTHER	FLORIDA	MEDICARE PTAN OHMG
4	N3348	OTHER	FLORIDA	MEDICARE PTAN OHRI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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