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AMANDA C WAGNER
NPI 1164058020
Nurse Anesthetist, Certified Registered in Rolla, MO

Active since March 22, 2020Accepts Medicare Assignment
94.18/100
CMS Quality Rating
1000 W 10TH ST, ROLLA, MO 65401(573) 458-8899(573) 341-5611 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 11, 2024, Mar 22, 2020 (2 updates tracked since 2020).

About Amanda C Wagner NPPES

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

AMANDA C WAGNER (NPI 1164058020) is an individual nurse anesthetist, certified registered in Rolla, Missouri, licensed in Missouri (2024020234) and active in the NPI registry since March 2020. She is affiliated with Phelps County Regional Medical Center, maintains a secondary practice location in Flushing, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1164058020
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameAMANDA C WAGNER
Location Address1000 W 10TH STRolla, MO 65401
Mailing Address1050 W 10th StRolla, MO 65401-2905 · (573) 458-8899 · Fax (573) 341-5611
Phone(573) 458-8899
Fax(573) 341-5611
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 22, 2020
Last NPPES UpdateSeptember 11, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2024
✔ NPI 1164058020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses✔ Licensed in MO · 2024020234✔ Licensed in FL · RN9407106✔ Licensed in NY · 786638
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1000 W 10TH ST, Rolla, MO 65401
Open in Google Maps ↗

Secondary Practice Location 1

Location 15645 Main StFlushing, NY 11355-5045 · Phone (718) 670-2000

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

Amanda C Wagner 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.

PECOS PAC ID648696450
PECOS Enrollment IDI20240726001080

Medicare Billing Reassignments

6

Medicare enrollment records show Amanda Wagner reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Phelps County Regional Medical Center
Same address
General Acute Care Hospital
1000 W 10TH ST
Rolla, MO 65401
  • Reassigned Medicare billing, Missouri enrollment
  • 28 clinicians in this Medicare group
NPI 1891766051 (573) 458-8899
Mercy Clinic-Springfield Communities
0.9 mi
Rural Health
1605 MARTIN SPRINGS DR STE 210
Rolla, MO 65401
  • Reassigned Medicare billing, Missouri enrollment
  • Also billed through NPI 1245277631 (Missouri)
  • 1,487 clinicians in this Medicare group
NPI 1811028723 (573) 458-6350
Mercy St. Francis Hospital
66 mi
Critical Access
100 WEST HIGHWAY 60
Mountain View, MO 65548
  • Reassigned Medicare billing, Missouri enrollment
  • 134 clinicians in this Medicare group
NPI 1023053477 (417) 934-7000
Medstream Anesthesia Hawaii, LLC
3,981 mi
Anesthesiology
67-1125 MAMALAHOA HWY
Kamuela, HI 96743
  • Reassigned Medicare billing, Hawaii enrollment
  • 68 clinicians in this Medicare group
NPI 1346621190 (828) 398-5244
Pacific Anesthesia, Inc
4,052 mi
Anesthesiology
321 N KUAKINI ST, STE 306
Honolulu, HI 96817
  • Reassigned Medicare billing, Hawaii enrollment
  • 171 clinicians in this Medicare group
NPI 1538472451 (808) 545-1557
Pec Anesthesia LLC
4,056 mi
Nurse Anesthetist, Certified Registered
1029 MAKOLU ST, STE H
Pearl City, HI 96782
  • Reassigned Medicare billing, Hawaii enrollment
  • 65 clinicians in this Medicare group
NPI 1528305208 (808) 456-6420

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Phelps County Regional Medical Center

Acute Care Hospitals · Rolla, MO
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number260017
Location1000 W 10th StRolla, MO 65401 · Phelps County
Emergency services Birthing friendly

Mercy Hospital Lebanon

Acute Care Hospitals · Lebanon, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260059
Location100 Hospital DriveLebanon, MO 65536 · Laclede County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65401 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
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

94.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.28
Promoting Interoperability100
Improvement Activities40

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.

OSAGE BONE AND JOINT CLINIC, INC
Orthopaedic Surgery
1000 W 10TH ST, STE A
ROLLA, MO 65401
Phelps County (573) 364-5633
MS. CANDY SADLER AGNP
Nurse Practitioner (Adult Health)
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 364-9000
AMERIPATH INDIANAPOLIS PC
Pathology (Anatomic Pathology & Clinical Pathology)
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 458-7050
KIMBERLEE RICHARDSON RN-DIABETES EDUCATOR
Registered Nurse (Diabetes Educator)
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 458-8899
BLAINE GOODMAN
Nurse Anesthetist, Certified Registered
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 458-8899
FRANK M. ELDERS D.O.
Emergency Medicine
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 364-3100
MRS. LORIE ANN BOURNE M.S., R.D., L.D.,
Dietitian, Registered
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 458-8337
ANGELA CHRISTINE MIDDLETON FNP-BC, CEN
Nurse Practitioner (Family)
1000 W 10TH ST
ROLLA, MO 65401
Phelps County (573) 458-8899

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 Amanda Wagner's NPI number?

The NPI number for Amanda Wagner is 1164058020. It was assigned to this individual provider in the NPPES registry on March 22, 2020.

Where is Amanda Wagner located?

Amanda Wagner practices at 1000 W 10th St, Rolla, MO 65401. The listed phone number is (573) 458-8899.

What is Amanda Wagner's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Amanda Wagner enrolled in Medicare?

Yes. Amanda 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 Amanda Wagner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Wagner reassigns Medicare benefits to 6 organizations: Phelps County Regional Medical Center (Rolla, MO), Mercy Clinic-Springfield Communities (Rolla, MO), Mercy St. Francis Hospital (Mountain View, MO), Medstream Anesthesia Hawaii, LLC (Kamuela, HI), Pacific Anesthesia, Inc (Honolulu, HI) and 1 more organization, listed in the Medicare section above. 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 Amanda Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Amanda Wagner affiliated with any hospitals?

According to CMS data, Amanda Wagner is affiliated with Phelps County Regional Medical Center and Mercy Hospital Lebanon.

When was this NPI record last updated?

The NPPES record for Amanda Wagner was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.