Amanda Ellen Wagner, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Stayton, Oregon. She graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Santiam Memorial Hospital and her current practice location is
1373 N 10th Ave, Stayton, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 769-9522.
Amanda Ellen Wagner is licensed to practice in Oregon (license number MD215626) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1235457359.
Physician's Profile
| Full Name | Amanda Ellen Wagner |
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| Gender | Female |
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| Speciality | Obstetrics/gynecology |
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| Experience | 19 Years |
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| Location | 1373 N 10th Ave, Stayton, Oregon |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Amanda Ellen Wagner graduated from medical school in 2005
NPI Data:
- NPI Number: 1235457359
- Provider Enumeration Date: 05/13/2010
- Last Update Date: 10/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 7416071402
- Enrollment ID: I20230919001865
Medical Identifiers
Medical identifiers for Amanda Ellen Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235457359 | NPI | - | NPPES |
| 7100131400 | Medicaid | KY | |
| P00947909 | Other | KY | RR MEDICARE |
| 500822477 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | 43867 (Kentucky) | Secondary |
| 207V00000X | Obstetrics & Gynecology | MD215626 (Oregon) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Santiam Memorial Hospital | 6103729751 | 82 |
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. Amanda Ellen Wagner allows following entities to bill medicare on her behalf.
| Entity Name | Santiam Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912178823
PECOS PAC ID: 6103729751
Enrollment ID: O20040130000239 |
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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. Amanda Ellen 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 |
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Amanda Ellen Wagner, MD
Po Box 577,
Stayton, OR 97383-0577
Ph: (503) 769-2175 | Amanda Ellen Wagner, MD
1373 N 10th Ave,
Stayton, OR 97383-2037
Ph: (503) 769-9522 |
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