| Paul A Wagner, DO | |
|
611 East Main St, Hart, MI 49420-1190 | |
| (231) 873-5675 | |
| (231) 873-1825 |
| Full Name | Paul A Wagner |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 40 Years |
| Location | 611 East Main St, Hart, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962434043 | NPI | - | NPPES |
| 3015197 | Medicaid | MI | |
| 3015197 TYPE 11 | Medicaid | MI | |
| 080058226 | Other | MI | MEDICARE RAILROAD |
| 010F476090 | Other | MI | BCBS |
| 0F40011 | Other | MI | BCBSMI |
| 5641515 | Other | MI | BCBS PIN NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PW011554 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | 5101011554 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Health Lakeshore Campus | Shelby, MI | Hospital |
| Mercy Health Hackley Campus | Muskegon, MI | Hospital |
| Spectrum Health Ludington Hospital | Ludington, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Health Partners | 1456430016 | 55 |
| Lakeshore Community Hospital Inc | 8224078993 | 16 |
| Entity Name | Mercy Health Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154910172 PECOS PAC ID: 1456430016 Enrollment ID: O20140415001839 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul A Wagner, DO 611 East Main Street, Hart, MI 49420-1190 Ph: (231) 873-5675 | Paul A Wagner, DO 611 East Main St, Hart, MI 49420-1190 Ph: (231) 873-5675 |
John P Cooney, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2481 N 72nd Ave, Hart, MI 49420 Phone: 231-873-2163 Fax: 231-873-2143 | |
Rudy C Ochs, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 611 E Main St, Hart, MI 49420 Phone: 231-873-5675 Fax: 231-873-1825 | |
Cynthia Ochs, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 611 E Main St, Hart, MI 49420 Phone: 231-873-5675 Fax: 231-873-1825 | |
Ronald E Graeser, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 611 E Main St, Hart, MI 49420 Phone: 231-873-5675 Fax: 231-873-3448 |