BRADFORD S. WAGNER MD
NPI 1083848030
Family Medicine - Sports Medicine in South Portland, ME

Q: What is Bradford Wagner's NPI number?

The NPI number for Bradford Wagner is 1083848030. It was assigned to this individual provider in the NPPES registry on May 6, 2009.

Q: What is Bradford Wagner's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Bradford Wagner was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.

Active since May 06, 2009PECOS Enrolled

50 FODEN RD STE 3, SOUTH PORTLAND, ME 04106(207) 874-1489(207) 523-8590 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 3, 2026, Oct 1, 2020 (2 updates tracked since 2020).

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About Bradford S. Wagner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADFORD S. WAGNER MD (NPI 1083848030) is an individual sports medicine provider in South Portland, Maine, licensed in Maine (MD19486) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS and is a graduate of University Of Massachusetts Medical School (2009).

NPPES Registry Identity

NPI1083848030

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameBRADFORD S. WAGNERCredential: MD

Location Address50 FODEN RD STE 3South Portland, ME 04106-1718

Mailing Address100 Gannett Dr Ste CSouth Portland, ME 04106-5900 · (207) 347-2947 · Fax (207) 874-2317

Phone(207) 874-1489

Fax(207) 523-8590

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2009

Enumeration DateMay 6, 2009

Last NPPES UpdateMarch 3, 20262 updates tracked since enumeration

NPPES CertifiedMarch 3, 2026

✔ NPI 1083848030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in ME · MD19486

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedFamily MedicineTaxonomy 207Q00000X · License MD19486 (ME)

50 FODEN RD STE 3, South Portland, ME 04106

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradford S. Wagner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456595313

PECOS Enrollment IDI20130913000640

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Bradford Wagner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mainehealth

0.9 mi

Gynecology

100 BRICKHILL AVE
South Portland, ME 04106

Reassigned Medicare billing, Maine enrollment
Also billed through NPI 1639194509 (Maine)
3,140 clinicians in this Medicare group

NPI 1679887400 (207) 775-1255

Intermed, PA

1.5 mi

Internal Medicine

100 GANNETT DR, SUITE C
South Portland, ME 04106

Reassigned Medicare billing, Maine enrollment
200 clinicians in this Medicare group

NPI 1467422733 (207) 828-0361

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 10

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.

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

78 services58 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

70 services70 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

53 services46 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

47 services42 patients

Hyaluronan or derivative, monovisc, for intra-articular injection, per dose J7327

Monovisc is a treatment involving an injection of hyaluronan or its derivative into a joint, often the knee. This substance, found naturally in joint fluid, helps lubricate and cushion the joint. The injection can help ease pain, improve mobility, and reduce inflammation caused by arthritis.

34 services23 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.72 typical visit price

range $56.28 – $169.96

Typical copayment $21.68 (range $14.07 – $42.49)

Most-billed visit code 99203

Established Patient

$99.18 typical visit price

range $18.22 – $138.92

Typical copayment $24.79 (range $4.55 – $34.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE RUTHERFORD MD

Pediatrics (Sports Medicine)