AMY L WAGONER MD
NPI 1376554568
Family Medicine in Watertown, SD

Q: What is Amy Wagoner's NPI number?

The NPI number for Amy Wagoner is 1376554568. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Q: What is Amy Wagoner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Wagoner was last updated on October 1, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 11, 2006PECOS Enrolled

901 4TH ST NW, WATERTOWN, SD 57201(605) 886-8471(605) 886-9317 Get Directions Write a Review

NPPES record last updated: October 1, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Amy L Wagoner Md NPPES

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

AMY L WAGONER MD (NPI 1376554568) is an individual family medicine provider in Watertown, South Dakota, licensed in South Dakota (8597) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Ortonville Area Health Services, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (1997).

NPPES Registry Identity

NPI1376554568

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameAMY L WAGONERCredential: MD

Location Address901 4TH ST NWWatertown, SD 57201-1558

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-6585 · Fax (605) 328-6512

Phone(605) 886-8471

Fax(605) 886-9317

Sole ProprietorNo

Medical School CMSSanford School Of Medicine Of University Of South DakotaGraduated 1997

Enumeration DateAugust 11, 2006

Last NPPES UpdateOctober 1, 2012

✔ NPI 1376554568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in SD · 8597✔ Licensed in WI · 40276

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

901 4TH ST NW, Watertown, SD 57201

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Other Identifiers 3

Medicaid32585100WI

Medicare ID-Type Unspecified001461030WI

Medicare UPINH19064WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amy L Wagoner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406939321

PECOS Enrollment IDI20121128000532

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.

Areas of Expertise CMS Part B claims 3

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.

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

162 services59 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

117 services53 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Ortonville Area Health Services

Critical Access Hospitals · Ortonville, MN

OwnershipGovernment - Local

CMS Certification Number241342

Location450 Eastvold AveOrtonville, MN 56278 · Big Stone County

Emergency services Birthing friendly

Prairie Lakes Healthcare System, Inc

Acute Care Hospitals · Watertown, SD

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430005

Location401 9th Avenue NW Post Office Box 1210Watertown, SD 57201 · Codington County

Emergency services Birthing friendly

Milbank Area Hospital/Avera Health

Critical Access Hospitals · Milbank, SD

OwnershipVoluntary non-profit - Private

CMS Certification Number431326

Location301 Flynn DriveMilbank, SD 57252 · Grant County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57201 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

$85.21 typical visit price

range $55.52 – $167.23

Typical copayment $21.30 (range $13.88 – $41.80)

Most-billed visit code 99203

Established Patient

$97.88 typical visit price

range $18.08 – $137.08

Typical copayment $24.47 (range $4.52 – $34.27)

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.

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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.

BETHANY K SCHULTZ CNP

Nurse Practitioner (Family)