BENJAMIN WAGNER MD
NPI 1205531266
Student in an Organized Health Care Education/Training Program in Portland, OR
About Benjamin Wagner Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BENJAMIN WAGNER MD (NPI 1205531266) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of University Of Nevada School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Benjamin Wagner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Benjamin Wagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97205
- Reassigned Medicare billing, Oregon enrollment
- 1,501 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.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 Benjamin Wagner's NPI number?
The NPI number for Benjamin Wagner is 1205531266. It was assigned to this individual provider in the NPPES registry on March 31, 2023.
Where is Benjamin Wagner located?
Benjamin Wagner practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (530) 494-8211.
What is Benjamin Wagner's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Benjamin Wagner enrolled in Medicare?
Yes. Benjamin Wagner is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Benjamin Wagner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Wagner reassigns Medicare benefits to Providence Health & Services - Oregon (Portland, OR). The 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 Benjamin 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 Benjamin Wagner was last updated on March 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Benjamin Wagner, MD · NPI 1205531266
Student in an Organized Health Care Education/Training Program provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 31, 2023.
## Identity
- **NPI:** 1205531266 (Entity type: Individual)
- **Enumerated:** March 31, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3098
- **Phone:** (530) 494-8211
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Providence Health & Services - Oregon (NPI 1235479643, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Nevada School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** March 31, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1205531266) · Data from the CMS NPPES public registry.