| Dr Richard Otto Wagner, MD | |
|
11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | |
| (952) 595-1301 | |
| (612) 294-4903 |
| Full Name | Dr Richard Otto Wagner |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 51 Years |
| Location | 11995 Singletree Ln Ste 500, Eden Prairie, Minnesota |
| 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 |
|---|---|---|---|
| 1194752683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 19448-020 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cox Medical Centers | Springfield, MO | Hospital |
| University Hospital S U N Y Health Science Center | Syracuse, NY | Hospital |
| Bassett Healthcare | Cooperstown, NY | Hospital |
| Cox Medical Center Branson | Branson, MO | Hospital |
| Metro Health Hospital | Wyoming, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Radiology Alliance Pc | 1850280470 | 301 |
| Mary Imogene Bassett Hospital | 3779488325 | 728 |
| Northside Radiology Associates Llc | 4486555398 | 256 |
| Virtual Radiologic Professionals Llc | 4981608817 | 394 |
| Donalsonville Hospital Inc | 7113919820 | 51 |
| Fred Smeltzer Md And Associates Inc | 8921078304 | 78 |
| Entity Name | Virtual Radiologic Professionals Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932342029 PECOS PAC ID: 4981608817 Enrollment ID: O20130710000322 |
| Entity Name | Shelin Agrawal And Hyer Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861783961 PECOS PAC ID: 5890955959 Enrollment ID: O20180523001340 |
| Entity Name | Donalsonville Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720095805 PECOS PAC ID: 7113919820 Enrollment ID: O20190226003046 |
| Entity Name | Northside Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013960657 PECOS PAC ID: 4486555398 Enrollment ID: O20200909000207 |
| Entity Name | Mary Imogene Bassett Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083664221 PECOS PAC ID: 3779488325 Enrollment ID: O20210302001982 |
| Entity Name | United Memorial Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669747085 PECOS PAC ID: 0547259376 Enrollment ID: O20230919002778 |
| Entity Name | Fred Smeltzer Md & Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639122286 PECOS PAC ID: 8921078304 Enrollment ID: O20240221000944 |
| Entity Name | Memphis Physicians Radiological Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134231574 PECOS PAC ID: 9830123736 Enrollment ID: O20240814001330 |
| Entity Name | Radiology Alliance Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861478489 PECOS PAC ID: 1850280470 Enrollment ID: O20250212000627 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard Otto Wagner, MD 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 Ph: (952) 595-1301 | Dr Richard Otto Wagner, MD 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 Ph: (952) 595-1301 |
Norna L. Karp, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Jacob Gebrael, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Stephen George Fox, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Dr. Trudy J Moore, MD Radiology Medicare: Medicare Enrolled Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Dr. Priti Bachubhai Ram, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Nathan J Groebner, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 7595 Anagram Dr, Eden Prairie, MN 55344 Phone: 612-573-2200 Fax: 612-573-2274 | |
Dr. Christopher James Macdonald, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 |