Mitchel Alan Wagner, DO - Medicare Emergency Medicine in Peoria, IL

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Mitchel Alan Wagner, DO is a medicare enrolled "Emergency Medicine" physician in Peoria, Illinois. His current practice location is 530 Ne Glen Oak Ave, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 655-2109.

Mitchel Alan Wagner is licensed to practice in Illinois (license number 036166029) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1609440684.

Contact Information

Mitchel Alan Wagner, DO
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001
(309) 655-2109
Not Available

Map and Direction




Physician's Profile

Full NameMitchel Alan Wagner
GenderMale
SpecialityEmergency Medicine
Location530 Ne Glen Oak Ave, Peoria, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1609440684
  • Provider Enumeration Date: 05/14/2021
  • Last Update Date: 10/03/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2567867971
  • Enrollment ID: I20240730002452

Medical Identifiers

Medical identifiers for Mitchel Alan Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609440684NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 036166029 (Illinois)Primary

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. Mitchel Alan Wagner allows following entities to bill medicare on his behalf.
Entity NameProsser Public Hospital District Of Benton County
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306897681
PECOS PAC ID: 6709787872
Enrollment ID: O20040120000974
Entity NameNorthwest Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235172370
PECOS PAC ID: 3476462334
Enrollment ID: O20041214000892

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. Mitchel Alan Wagner 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
Mitchel Alan Wagner, DO
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001

Ph: (309) 655-2109		Mitchel Alan Wagner, DO
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001

Ph: (309) 655-2109

Reviews and Comments


Emergency Medicine Doctors in Peoria, IL

Austin J Lamb, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637
Phone: 309-655-7257    
Philip A Fifield, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Brittain Utah Ladd, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Dr. Anthony J Buecker, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636
Phone: 309-672-5500    
Dr. Mark Phillip Gaudio, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-6710    
Michael M Raso, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1115 N Bourland Ave, Peoria, IL 61606
Phone: 309-264-0730    
Joseph Devito, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave Bldg Room2620, Peoria, IL 61637
Phone: 309-655-6710    

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.

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