Jack Wagoner, MD - Medicare General Surgery in Sycamore, IL

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Jack Wagoner, MD is a medicare enrolled "Surgery" physician in Sycamore, Illinois. He went to Southern Illinois University School Of Medicine and graduated in 1993 and has 32 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Central Dupage Physician Group and his current practice location is 1850 Gateway Dr, Sycamore, Illinois. You can reach out to his office (for appointments etc.) via phone at (815) 758-8671.

Jack Wagoner is licensed to practice in Illinois (license number 036-100314) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1518979665.

Contact Information

Jack Wagoner, MD
1850 Gateway Dr,
Sycamore, IL 60178-3192
(815) 758-8671
(815) 758-5610

Map and Direction




Physician's Profile

Full NameJack Wagoner
GenderMale
SpecialityGeneral Surgery
Experience32 Years
Location1850 Gateway Dr, Sycamore, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jack Wagoner attended and graduated from Southern Illinois University School Of Medicine in 1993
  NPI Data:
  • NPI Number: 1518979665
  • Provider Enumeration Date: 08/13/2006
  • Last Update Date: 06/11/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 8527964824
  • Enrollment ID: I20101201000246

Medical Identifiers

Medical identifiers for Jack Wagoner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1518979665NPI-NPPES
048118OtherILHEALTH ALLIANCE
036100314MedicaidIL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery 036-100314 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kishwaukee Community HospitalDekalb, ILHospital
Central Dupage HospitalWinfield, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Central Dupage Physician Group58906962311005

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jack Wagoner allows following entities to bill medicare on his behalf.
Entity NameCentral Dupage Physician Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033149844
PECOS PAC ID: 5890696231
Enrollment ID: O20040303000601
Entity NameKishwaukee Physician Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932480605
PECOS PAC ID: 3870768054
Enrollment ID: O20111216000435

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Wagoner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jack Wagoner, MD
1850 Gateway Dr,
Sycamore, IL 60178-3192

Ph: (815) 758-8671		Jack Wagoner, MD
1850 Gateway Dr,
Sycamore, IL 60178-3192

Ph: (815) 758-8671

Reviews and Comments


Surgery Doctors in Sycamore, IL

Stephen Goldman, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1850 Gateway Dr, Sycamore, IL 60178
Phone: 815-758-8671    
Roger Maillefer, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1850 Gateway Dr, Sycamore, IL 60178
Phone: 815-758-8671    
Nitzet Velez, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1850 Gateway Dr, Sycamore, IL 60178
Phone: 815-758-8671    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.