Blake Douglas Wagner, PT in Fremont, NE - Medicare Physical Therapy Provider

Blake Douglas Wagner, PT is a medicare enrolled "Physical Therapist" provider in Fremont, Nebraska. He graduated from medical school in 1991 and has 33 years of diverse experience with area of expertise as Physical Therapy. He is a member of the group practice Dpt Holdings Llc and his current practice location is 410 E 22nd St Ste 2, Fremont, Nebraska. You can reach out to his office (for appointments etc.) via phone at (800) 974-4378.

Blake Douglas Wagner is licensed to practice in Nebraska (license number 1004) 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 1811057664.

Contact Information

	Blake Douglas Wagner, PT
	410 E 22nd St Ste 2, Fremont, NE 68025-2640
	(800) 974-4378
	(630) 515-1536

Map and Direction

Healthcare Provider's Profile

Full Name	Blake Douglas Wagner
Gender	Male
Speciality	Physical Therapy
Experience	33 Years
Location	410 E 22nd St Ste 2, Fremont, Nebraska
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Blake Douglas Wagner graduated from medical school in 1991

NPI Data:

NPI Number: 1811057664
Provider Enumeration Date: 12/11/2006
Last Update Date: 10/30/2023

Medicare PECOS Information:

PECOS PAC ID: 5193726396
Enrollment ID: I20151217000150

Medical Identifiers

Medical identifiers for Blake Douglas Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811057664	NPI	-	NPPES
29675	Other	IA	BCBS IA-WELLMARK
0762989	Medicaid	IA
P00636067	Other	IA	RR MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	01883 (Iowa)	Secondary
225100000X	Physical Therapist	1004 (Nebraska)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Dpt Holdings Llc	4688679293	173

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. Blake Douglas Wagner allows following entities to bill medicare on his behalf.

Provider Name	Dpt Holdings Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1689648602 PECOS PAC ID: 4688679293 Enrollment ID: O20230919001715

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. Blake Douglas 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 Address	Practice Location Address
Blake Douglas Wagner, PT 24014 W Renwick Rd Unit 206, Plainfield, IL 60544-8711 Ph: (800) 974-4378	Blake Douglas Wagner, PT 410 E 22nd St Ste 2, Fremont, NE 68025-2640 Ph: (800) 974-4378

Reviews and Comments

Physical Therapist in Fremont, NE

Fremont Therapy And Wellness Physical Therapist Medicare: Medicare Enrolled Practice Location: 410 N Bell St, Fremont, NE 68025 Phone: 402-512-3893
Nebraska Orthopaedic Physical Therapy Pc Physical Therapist Medicare: Medicare Enrolled Practice Location: 2123 E 23rd Ave S, Fremont, NE 68025 Phone: 402-721-1112 Fax: 402-721-1113
Chelsea M Jenner, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 410 E 22nd St, Fremont, NE 68025 Phone: 402-721-3908 Fax: 402-721-4047
Christine Montes, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 450 E 23rd St, Fremont, NE 68025 Phone: 402-727-3772
Alexandra T Muessel, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3301 E Elkhorn Dr Ste 200, Fremont, NE 68025 Phone: 402-721-0235 Fax: 402-721-6167
Dr. Jamie Mae Larsen, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1445 N Bell St, Fremont, NE 68025 Phone: 402-512-3893
Zachary J Girthoffer, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2740 N Clarkson St, Suite 200, Fremont, NE 68025 Phone: 402-721-0235

Blake Douglas Wagner, PT - Medicare Physical Therapist in Fremont, NE