Dr Timothy R Wagner, MD is a medicare enrolled "Orthopaedic Surgery" physician in Lake City, South Carolina. His current practice location is
330 Mercy Street, Lake City, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 374-6431.
Dr Timothy R Wagner is licensed to practice in Kentucky (license number 29577) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1306899539.
Physician's Profile
Full Name | Dr Timothy R Wagner |
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Gender | Male |
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Speciality | Orthopaedic Surgery |
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Location | 330 Mercy Street, Lake City, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1306899539
- Provider Enumeration Date: 05/18/2006
- Last Update Date: 01/28/2014
Medicare PECOS Information:
- PECOS PAC ID: 0749207306
- Enrollment ID: I20051102000239
Medical Identifiers
Medical identifiers for Dr Timothy R Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306899539 | NPI | - | NPPES |
64295777 | Medicaid | KY | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207X00000X | Orthopaedic Surgery | 29577 (Kentucky) | Primary |
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 Timothy R Wagner allows following entities to bill medicare on his behalf.
Entity Name | Lower Florence County Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902903222 PECOS PAC ID: 6608802152 Enrollment ID: O20050808000493 |
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Entity Name | Prisma Health Medical Group-midlands |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1275988321 PECOS PAC ID: 5991099707 Enrollment ID: O20160802001226 |
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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. Dr Timothy R 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 |
Dr Timothy R Wagner, MD 330 Mercy St, Lake City, SC 29560-2332 Ph: (843) 374-6431 | Dr Timothy R Wagner, MD 330 Mercy Street, Lake City, SC 29560 Ph: (843) 374-6431 |
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