Mr Phillip Leroy Wagner, MD in Vallejo, CA - Medicare Preventive Medicine

Mr Phillip Leroy Wagner, MD is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Vallejo, California. His current practice location is 975 Sereno Dr, Occupational Medicine, Vallejo, California. You can reach out to his office (for appointments etc.) via phone at (707) 651-2243.

Mr Phillip Leroy Wagner is licensed to practice in New Mexico (license number 20060083) 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 1912931619.

Contact Information

	Mr Phillip Leroy Wagner, MD
	975 Sereno Dr, Occupational Medicine, Vallejo, CA 94589-2441
	(707) 651-2243
	Not Available

Map and Direction

Physician's Profile

Full Name	Mr Phillip Leroy Wagner
Gender	Male
Speciality	Preventive Medicine - Occupational Medicine
Location	975 Sereno Dr, Vallejo, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912931619
Provider Enumeration Date: 07/10/2006
Last Update Date: 12/15/2021

Medicare PECOS Information:

PECOS PAC ID: 4082613443
Enrollment ID: I20150114000593

Medical Identifiers

Medical identifiers for Mr Phillip Leroy Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912931619	NPI	-	NPPES
087585	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2083X0100X	Preventive Medicine - Occupational Medicine	20060083 (New Mexico)	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. Mr Phillip Leroy Wagner allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Mr Phillip Leroy 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
Mr Phillip Leroy Wagner, MD 1220 Illinois St, Vallejo, CA 94590-3910 Ph: (707) 246-5744	Mr Phillip Leroy Wagner, MD 975 Sereno Dr, Occupational Medicine, Vallejo, CA 94589-2441 Ph: (707) 651-2243

Reviews and Comments

Preventive Medicine Doctors in Vallejo, CA

Brian E. Knapp, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 975 Sereno Dr, Vallejo, CA 94589 Phone: 707-651-1000
Jeffrey L. Gao, MD Preventive Medicine Medicare: Medicare Enrolled Practice Location: 975 Sereno Dr, Vallejo, CA 94589 Phone: 707-651-1000
Susan D. Lambert, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 975 Sereno Dr, Vallejo, CA 94589 Phone: 707-651-1000
Michael A. Palomino, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 975 Sereno Dr, Vallejo, CA 94589 Phone: 707-651-1000

Mr Phillip Leroy Wagner, MD - Medicare Preventive Medicine in Vallejo, CA