MARIAH M WAGNER PA-C
NPI 1407329246
Physician Assistant in Johnson City, TN

Q: What is Mariah Wagner's NPI number?

The NPI number for Mariah Wagner is 1407329246. It was assigned to this individual provider in the NPPES registry on January 4, 2019. The provider is also known as Mariah Ngo Pa-C.

Q: What is Mariah Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mariah Wagner was last updated on October 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since January 04, 2019PECOS EnrolledAccepts Medicare Assignment

2410 SUSANNAH ST, JOHNSON CITY, TN 37601(423) 282-9011(423) 282-0035 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 14, 2020, Dec 17, 2019, Jan 4, 2019 (3 updates tracked since 2019).

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About Mariah M Wagner Pa-c NPPES

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

MARIAH M WAGNER PA-C (NPI 1407329246) is an individual physician assistant in Johnson City, Tennessee, licensed in Tennessee (3690) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Lincoln Memorial University Medical Department (2018).

NPPES Registry Identity

NPI1407329246

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMARIAH M WAGNERCredential: PA-C

Location Address2410 SUSANNAH STJohnson City, TN 37601-1748

Mailing Address2410 Susannah StJohnson City, TN 37601-1748 · (423) 282-9011 · Fax (423) 282-0035

Phone(423) 282-9011

Fax(423) 282-0035

Sole ProprietorNo

Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2018

Enumeration DateJanuary 4, 2019

Last NPPES UpdateOctober 14, 20203 updates tracked since enumeration

NPPES CertifiedOctober 14, 2020

✔ NPI 1407329246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TN · 3690

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2410 SUSANNAH ST, Johnson City, TN 37601

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Other Names 1

Former Name (1)Mariah Ngo Pa-c

Secondary Practice Locations 2

Location 1875 Larry Neil WayKingsport, TN 37660-6368 · Phone (423) 282-9011 · Fax (423) 282-0035

Location 2340 Steeles RdBristol, TN 37620 · Phone (423) 282-9011

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mariah M Wagner Pa-c 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.

PECOS PAC ID6204176928

PECOS Enrollment IDI20210514000498

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 2

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

108 services44 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

68 services68 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37601 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

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 20

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

RICHARD W DUNCAN MD

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