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KIRSTIN LYNETTE WAGNER PA-C
NPI 1376912212
Physician Assistant - Surgical in Los Angeles, CA

Active since September 22, 2015PECOS Enrolled
1520 SAN PABLO ST STE 4300, LOS ANGELES, CA 90033(323) 442-5849 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jul 10, 2017 (3 updates tracked since 2017).

About Kirstin Lynette Wagner Pa-c NPPES

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

KIRSTIN LYNETTE WAGNER PA-C (NPI 1376912212) is an individual surgical provider in Los Angeles, California, licensed in California (PA52754) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Seattle.

NPPES Registry Identity

NPI1376912212
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKIRSTIN LYNETTE WAGNERCredential: PA-C
Location Address1520 SAN PABLO ST STE 4300Los Angeles, CA 90033-5330
Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (323) 442-5849
Phone(323) 442-5849
Sole ProprietorNo
Enumeration DateSeptember 22, 2015
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1376912212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CA · PA52754
1520 SAN PABLO ST STE 4300, Los Angeles, CA 90033
Open in Google Maps ↗

Secondary Practice Location 1

Location 12701 California Ave SW, #614Seattle, WA 98116-2405 · Phone (425) 922-0640

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kirstin Lynette Wagner Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. MATTHEW E POWERS M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849
NIDAL ALKAFARNA
Physician Assistant (Surgical)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849
JAYNITA HASMUKH PATEL RD
Dietitian, Registered
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-6964
DR. SANJEET GIRISH PATEL MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849
DR. JONATHAN AARON PRAEGER M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849
CHERILYN R TARALLO NP
Nurse Practitioner (Acute Care)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849
ELIZABETH ANTONIO MIRANDA MPH
Surgery (Vascular Surgery)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5755
RAYMOND CHURK-YIN LEE M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1520 SAN PABLO ST STE 4300
LOS ANGELES, CA 90033
Los Angeles County (323) 442-5849

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 Kirstin Wagner's NPI number?

The NPI number for Kirstin Wagner is 1376912212. It was assigned to this individual provider in the NPPES registry on September 22, 2015.

Where is Kirstin Wagner located?

Kirstin Wagner practices at 1520 San Pablo St Ste 4300, Los Angeles, CA 90033. The listed phone number is (323) 442-5849.

What is Kirstin Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kirstin Wagner enrolled in Medicare?

Yes. Kirstin Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kirstin Wagner was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.