| Ryan J Wagner, | |
|
2400 E Capitol Dr, Appleton, WI 54911-8728 | |
| (920) 454-3300 | |
| (920) 531-2098 |
| Full Name | Ryan J Wagner |
|---|---|
| Gender | Male |
| Speciality | Sports Medicine |
| Experience | 11 Years |
| Location | 2400 E Capitol Dr, Appleton, Wisconsin |
| 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 |
|---|---|---|---|
| 1275087207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207PS0010X | Emergency Medicine - Sports Medicine | 68001 (Wisconsin) | Primary |
| 207X00000X | Orthopaedic Surgery | 68001 (Wisconsin) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thedacare Regional Medical Center - Appleton Inc | Appleton, WI | Hospital |
| Thedacare Medical Center-waupaca | Waupaca, WI | Hospital |
| Thedacare Regional Med Ctr - Neenah | Neenah, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thedacare Incorporated | 1759294887 | 533 |
| Entity Name | Thedacare Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan J Wagner, 2400 E Capitol Dr, Appleton, WI 54911-8728 Ph: (920) 831-5050 | Ryan J Wagner, 2400 E Capitol Dr, Appleton, WI 54911-8728 Ph: (920) 454-3300 |
Kirsten W Larson, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3329 N Richmond Street, Appleton, WI 54911 Phone: 920-380-2715 | |
Michael D Polka, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-4101 | |
Cyril Walsh, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 800-968-6866 | |
Ronald J Krajnik, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3925 N Gateway Dr, Appleton, WI 54913 Phone: 920-702-6371 | |
Reid A Sousek, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3329 N Richmond St, Appleton, WI 54911 Phone: 920-380-2720 | |
Steven J Mcintyre, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 800-968-6866 |