Ms Nicole Wagner, APN is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Wauconda, Illinois. She went to Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University and graduated in 2001 and has 23 years of diverse experience with area of expertise as Certified Clinical Nurse Specialist (cns). She is a member of the group practice Family Medicine Specialists S.c., Family Medicine Specialists Of Round Lake Incorporated S C and her current practice location is
431 W Liberty St, Wauconda, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 526-2151.
Ms Nicole Wagner is licensed to practice in Illinois (license number 209004749) 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 1194968602.
Provider's Profile
Full Name | Ms Nicole Wagner |
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Gender | Female |
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Speciality | Certified Clinical Nurse Specialist (cns) |
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Experience | 23 Years |
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Location | 431 W Liberty St, Wauconda, Illinois |
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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. |
Medical Education and Training:
- Ms Nicole Wagner attended and graduated from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 2001
NPI Data:
- NPI Number: 1194968602
- Provider Enumeration Date: 04/14/2009
- Last Update Date: 06/24/2019
Medicare PECOS Information:
- PECOS PAC ID: 9133418577
- Enrollment ID: I20160525000945
Medical Identifiers
Medical identifiers for Ms Nicole Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194968602 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 209004749 (Illinois) | Secondary |
364SA2200X | Clinical Nurse Specialist - Adult Health | 209004749 (Illinois) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Family Medicine Specialists S.c. | 0042206252 | 26 |
Family Medicine Specialists Of Round Lake Incorporated S C | 6002957511 | 18 |
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. Ms Nicole Wagner allows following entities to bill medicare on her behalf.
Entity Name | Family Medicine Specialists S.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1063406601 PECOS PAC ID: 0042206252 Enrollment ID: O20040422001425 |
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Entity Name | Family Medicine Specialists Of Round Lake Incorporated S C |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1740515253 PECOS PAC ID: 6002957511 Enrollment ID: O20100106000383 |
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Entity Name | Family Medicine Specialists Of Mount Prospect S C |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1437389475 PECOS PAC ID: 8224166566 Enrollment ID: O20100507000184 |
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Entity Name | All Time Urgent And Medical Care Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609536887 PECOS PAC ID: 3678969573 Enrollment ID: O20220401000198 |
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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. Ms Nicole 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 |
Ms Nicole Wagner, APN Po Box 6037, Wauconda, IL 60084 Ph: (847) 526-2151 | Ms Nicole Wagner, APN 431 W Liberty St, Wauconda, IL 60084-2452 Ph: (847) 526-2151 |
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