MR. WILLIS H. WAGNER M.D.
NPI 1003836248
Surgery - Vascular Surgery in Los Angeles, CA
About Mr. Willis H. Wagner M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. WILLIS H. WAGNER M.D. (NPI 1003836248) is an individual vascular surgery provider in Los Angeles, California, licensed in California (G049464) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1981).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Willis H. Wagner M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Willis Wagner reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Los Angeles, CA 90048
- Reassigned Medicare billing, California enrollment
- 6 clinicians in this Medicare group
Los Angeles, CA 90048
- Reassigned Medicare billing, California enrollment
- 6 clinicians in this Medicare group
Los Angeles, CA 90048
- Reassigned Medicare billing, California enrollment
- 1,001 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 14
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90048
LOS ANGELES, CA 90048
LOS ANGELES, CA 90048
LOS ANGELES, CA 90048
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Willis Wagner's NPI number?
The NPI number for Willis Wagner is 1003836248. It was assigned to this individual provider in the NPPES registry on July 20, 2006.
Where is Willis Wagner located?
Willis Wagner practices at 8631 W 3rd St Suite 615E, Los Angeles, CA 90048. The listed phone number is (310) 652-8132.
What is Willis Wagner's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is Willis Wagner enrolled in Medicare?
Yes. Willis Wagner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Willis Wagner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Willis Wagner reassigns Medicare benefits to 3 organizations: Vascular Surgery Associates (Los Angeles, CA), Vascular Surgery Associates (Los Angeles, CA) and Cedars-Sinai Medical Center (Los Angeles, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Willis Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Willis Wagner was last updated on October 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Willis H. Wagner, M.D. · NPI 1003836248
Vascular Surgery physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since July 20, 2006.
## Identity
- **NPI:** 1003836248 (Entity type: Individual)
- **Enumerated:** July 20, 2006
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **State license:** G049464 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 8631 W 3RD ST, SUITE 615E, Los Angeles, CA 90048-5901
- **Phone:** (310) 652-8132 · **Fax:** (310) 659-3815
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Vascular Surgery Associates (NPI 1538871686, Los Angeles, CA); Vascular Surgery Associates (NPI 1154341691, Los Angeles, CA); Cedars-Sinai Medical Center (NPI 1639172372, Los Angeles, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1981
## Record status
- **NPPES last updated:** October 8, 2007
- **Other identifiers:** Medicare PIN WG49464D (CA); Medicare PIN WG49464K (CA); Medicare UPIN C86940
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Source: [NPI Profile](https://npiprofile.com/npi/1003836248) · Data from the CMS NPPES public registry.