Ms Ellen A Wagner, CRNA | |
265 Herrick Road, Southampton, NY 11968 | |
(631) 726-8350 | |
(631) 726-8519 |
Full Name | Ms Ellen A Wagner |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 43 Years |
Location | 265 Herrick Road, Southampton, New York |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568408789 | NPI | - | NPPES |
P00164249 | Other | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 3472891 (New York) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | APRN03496 (Rhode Island) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Our Lady Of Fatima Hospital | North providence, RI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Narragansett Bay Anesthesia Llc | 5991774929 | 109 |
Entity Name | Narragansett Bay Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861445728 PECOS PAC ID: 5991774929 Enrollment ID: O20040928000003 |
Entity Name | South County Anesthesia Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790193522 PECOS PAC ID: 2062735053 Enrollment ID: O20141224000069 |
Entity Name | Anesthesia Partners Of New England Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326672312 PECOS PAC ID: 2365835428 Enrollment ID: O20220214000313 |
Mailing Address | Practice Location Address |
---|---|
Ms Ellen A Wagner, CRNA 455 Toll Gate Rd, Prc And Credentialing, Warwick, RI 02886 Ph: (401) 273-0641 | Ms Ellen A Wagner, CRNA 265 Herrick Road, Southampton, NY 11968 Ph: (631) 726-8350 |
Mr. Robert Mineo, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 265 Herrick Road, Southampton, NY 11968 Phone: 631-726-8350 Fax: 631-726-8519 | |
Catherine Anne Ruggiero, DNP, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 240 Meeting House Ln, Southampton, NY 11968 Phone: 631-726-8200 |