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LYNN K WAGNER MD
NPI 1164458899
Emergency Medicine in De Pere, WI

Active since June 24, 2006Opted out of Medicare · through Oct 30, 2027
106 N WISCONSIN ST, DE PERE, WI 54115(920) 327-7056 Get Directions Write a Review

NPPES record last updated: May 22, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lynn K Wagner Md NPPES

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

LYNN K WAGNER MD (NPI 1164458899) is an individual emergency medicine provider in De Pere, Wisconsin, licensed in Wisconsin (49400) and active in the NPI registry since June 2006. She has opted out of Medicare through October 30, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1164458899
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameLYNN K WAGNERCredential: MD
Location Address106 N WISCONSIN STDe Pere, WI 54115
Mailing Address164 N BroadwayGreen Bay, WI 54303-2728 · (920) 490-9046 · Fax (920) 405-5388
Phone(920) 327-7056
Sole ProprietorNo
Enumeration DateJune 24, 2006
Last NPPES UpdateMay 22, 2018
✔ NPI 1164458899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in WI · 49400✔ Licensed in CA · A89772
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
106 N WISCONSIN ST, De Pere, WI 54115
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Other Names 1

Former Name (1)Lynn K Lulloff Md

Other Identifiers 3

Medicaid34870800WI
OtherP00355797WI · Railroad
Medicaid104894116MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lynn K Wagner Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 30, 2023 through October 30, 2027.

Opt-Out Effective DateOctober 30, 2023
Opt-Out In Effect ThroughOctober 30, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54115 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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

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

LKW HEALTH LLC
Clinic/Center (Medical Specialty)
106 N WISCONSIN ST
DE PERE, WI 54115
Brown County (920) 327-7056

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 Lynn Wagner's NPI number?

The NPI number for Lynn Wagner is 1164458899. It was assigned to this individual provider in the NPPES registry on June 24, 2006. The provider is also known as Lynn K Lulloff MD.

Where is Lynn Wagner located?

Lynn Wagner practices at 106 N Wisconsin St, De Pere, WI 54115. The listed phone number is (920) 327-7056.

What is Lynn Wagner's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Lynn Wagner enrolled in Medicare?

No. Lynn Wagner has opted out of Medicare through October 30, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Lynn Wagner accept?

Health plans from CareSource (Common Ground Healthcare) list Lynn Wagner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lynn Wagner was last updated on May 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.