Ryan J Wagner, - Medicare Sports Medicine in Appleton, WI

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Ryan J Wagner, is a medicare enrolled "Emergency Medicine - Sports Medicine" physician in Appleton, Wisconsin. He went to Midwestern University, Chicago College Of Osteopathic Med and graduated in 2014 and has 10 years of diverse experience with area of expertise as Sports Medicine. He is a member of the group practice Thedacare Incorporated and his current practice location is 2400 E Capitol Dr, Appleton, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 454-3300.

Ryan J Wagner is licensed to practice in Wisconsin (license number 68001) 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 1275087207.

Contact Information

Ryan J Wagner,
2400 E Capitol Dr,
Appleton, WI 54911-8728
(920) 454-3300
(920) 531-2098

Map and Direction




Physician's Profile

Full NameRyan J Wagner
GenderMale
SpecialitySports Medicine
Experience10 Years
Location2400 E Capitol Dr, Appleton, Wisconsin
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:
  • Ryan J Wagner attended and graduated from Midwestern University, Chicago College Of Osteopathic Med in 2014
  NPI Data:
  • NPI Number: 1275087207
  • Provider Enumeration Date: 08/08/2016
  • Last Update Date: 02/29/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0547558041
  • Enrollment ID: I20180206002309

Medical Identifiers

Medical identifiers for Ryan J Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275087207NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PS0010XEmergency Medicine - Sports Medicine 68001 (Wisconsin)Primary
207X00000XOrthopaedic Surgery 68001 (Wisconsin)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Thedacare Regional Medical Center - Appleton IncAppleton, WIHospital
Thedacare Medical Center-waupacaWaupaca, WIHospital
Thedacare Regional Med Ctr - NeenahNeenah, WIHospital
Thedacare Medical Center - Wild RoseWild rose, WIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Thedacare Incorporated1759294887493

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. Ryan J Wagner allows following entities to bill medicare on his behalf.
Entity NameThedacare Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376656959
PECOS PAC ID: 1759294887
Enrollment ID: O20031106000088
Entity NameMercy Health System Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031113000164
Entity NameIhc-st Nicholas Emergency Physicians, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245288836
PECOS PAC ID: 2264403021
Enrollment ID: O20040804001040

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. Ryan J 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
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

Reviews and Comments


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Kirsten W Larson, MD
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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.