Dr Blake Douglas Wagner Jr, PHD in Mansfield, OH - Medicare Clinical Psychologist Provider

Dr Blake Douglas Wagner Jr, PHD is a medicare enrolled "Psychologist" provider in Mansfield, Ohio. He graduated from medical school in 1988 and has 37 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice New Directions Eap Inc and his current practice location is 1575 Marion Ave, Mansfield, Ohio. You can reach out to his office (for appointments etc.) via phone at (419) 529-9941.

Dr Blake Douglas Wagner Jr is licensed to practice in Ohio (license number I-4127) 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 1013069061.

Contact Information

	Dr Blake Douglas Wagner Jr, PHD
	1575 Marion Ave, Mansfield, OH 44906-3409
	(419) 529-9941
	(419) 529-0496

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Blake Douglas Wagner Jr
Gender	Male
Speciality	Clinical Psychologist
Experience	37 Years
Location	1575 Marion Ave, Mansfield, Ohio
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:

Dr Blake Douglas Wagner Jr graduated from medical school in 1988

NPI Data:

NPI Number: 1013069061
Provider Enumeration Date: 01/18/2007
Last Update Date: 09/02/2008

Medicare PECOS Information:

PECOS PAC ID: 3971498205
Enrollment ID: I20040218000255

Medical Identifiers

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

Identifier	Type	State	Issuer
1013069061	NPI	-	NPPES
000000315185	Other		ANTHEM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	I-4127 (Ohio)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
New Directions Eap Inc	3375438609	3

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

Entity Name	New Directions Eap Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295887222 PECOS PAC ID: 3375438609 Enrollment ID: O20040217000238

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. Dr Blake Douglas Wagner Jr 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
Dr Blake Douglas Wagner Jr, PHD 1575 Marion Ave, Mansfield, OH 44906-3409 Ph: (419) 529-9941	Dr Blake Douglas Wagner Jr, PHD 1575 Marion Ave, Mansfield, OH 44906-3409 Ph: (419) 529-9941

Reviews and Comments

Psychologist in Mansfield, OH

Dr. Ellen F. Stark, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1150 N Main St, Mansfield, OH 44903 Phone: 419-525-4455
Wade Brill, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1001 Olivesburg Rd, Mansfield, OH 44905 Phone: 419-526-2100 Fax: 419-521-2822
Bradley Fox, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 741 Scholl Rd, Mansfield, OH 44907 Phone: 419-774-6757 Fax: 419-756-2594
Rhonda Curtis, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1153 Woodland Rd, Mansfield, OH 44907 Phone: 419-756-8442
Kelly Elizabeth Roudabush-patel, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 856 W Cook Rd, Mansfield, OH 44907 Phone: 419-525-6400
Dr. Dennis Andrew Marikis, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 788 Lexington Ave, Mansfield, OH 44907 Phone: 419-756-2828 Fax: 417-753-9913

Dr Blake Douglas Wagner Jr, PHD - Medicare Psychologist in Mansfield, OH