DR. DAVID WAGNER PHD
NPI 1356730139
Psychologist - Clinical in Portland, OR
About Dr. David Wagner Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DAVID WAGNER PHD (NPI 1356730139) is an individual clinical provider in Portland, Oregon, licensed in Oregon (2558) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS and is a graduate of University Of Missouri, Columbia School Of Medicine (2013).
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 and accepts Medicare assignment
Dr. David Wagner Phd 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 Reassignment
Medicare enrollment records show David Wagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97239
- Reassigned Medicare billing, Oregon enrollment
- 2,212 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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
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 David Wagner's NPI number?
The NPI number for David Wagner is 1356730139. It was assigned to this individual provider in the NPPES registry on January 15, 2015.
Where is David Wagner located?
David Wagner practices at 707 SW Gaines St, Portland, OR 97239. The listed phone number is (503) 494-7899.
What is David Wagner's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is David Wagner enrolled in Medicare?
Yes. David 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 organization bills Medicare for David Wagner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Wagner reassigns Medicare benefits to University Professional Services (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 David 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 David Wagner was last updated on January 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Dr. David Wagner, PHD · NPI 1356730139
Clinical provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since January 15, 2015.
## Identity
- **NPI:** 1356730139 (Entity type: Individual)
- **Enumerated:** January 15, 2015
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 2558 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 707 SW GAINES ST, Portland, OR 97239-2901
- **Phone:** (503) 494-7899 · **Fax:** (503) 494-6868
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** University Professional Services (NPI 1073767588, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Missouri, Columbia School Of Medicine, class of 2013
## Record status
- **NPPES last updated:** January 15, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1356730139) · Data from the CMS NPPES public registry.