JACQUELINE LEE WAGNER ARNP
NPI 1447598362
Family Medicine in Coeur D Alene, ID

Q: What is Jacqueline Wagner's NPI number?

The NPI number for Jacqueline Wagner is 1447598362. It was assigned to this individual provider in the NPPES registry on January 28, 2013. The provider is also known as Jacqueline Lee Cruz-Aedo.

Q: What is Jacqueline Wagner'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 Jacqueline Wagner was last updated on August 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 28, 2013PECOS EnrolledAccepts Medicare Assignment

1713 E SHERMAN AVE, COEUR D ALENE, ID 83814(208) 966-4087(208) 966-4031 Get Directions Write a Review

NPPES record last updated: August 17, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jacqueline Lee Wagner Arnp NPPES

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

JACQUELINE LEE WAGNER ARNP (NPI 1447598362) is an individual family medicine provider in Coeur D Alene, Idaho, licensed in Idaho (NP1283A) and active in the NPI registry since January 2013. She is enrolled in Medicare PECOS, is affiliated with Northwest Specialty Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1447598362

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameJACQUELINE LEE WAGNERCredential: ARNP

Location Address1713 E SHERMAN AVECoeur D Alene, ID 83814-5326

Mailing Address1713 E Sherman AveCoeur D Alene, ID 83814-5326 · (208) 966-4087 · Fax (208) 966-4031

Phone(208) 966-4087

Fax(208) 966-4031

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateJanuary 28, 2013

Last NPPES UpdateAugust 17, 2016

✔ NPI 1447598362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · NP1283A

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.

1713 E SHERMAN AVE, Coeur D Alene, ID 83814

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Other Names 1

Former Name (1)Jacqueline Lee Cruz-aedo

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska.Insurance ›

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

Jacqueline Lee Wagner Arnp 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 ID7315187093

PECOS Enrollment IDI20140407000617

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.

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.

200 services44 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

46 services28 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services23 patients

Hospital Affiliations CMS Care Compare

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

Northwest Specialty Hospital

Acute Care Hospitals · Post Falls, ID

OwnershipProprietary

CMS Certification Number130066

Location1593 East Polston AvenuePost Falls, ID 83854 · Kootenai County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

Other Providers at the Same Location NPPES 2

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

MONARCH MENTAL HEALTH

Community/Behavioral Health

1713 E SHERMAN AVE
COEUR D ALENE, ID 83814

Kootenai County (208) 676-1075

LANETTE GAY LIVINGSTON-CLARK M.ED LPC

Counselor (Professional)

1713 E SHERMAN AVE
COEUR D ALENE, ID 83814

Kootenai County (208) 651-0557

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 Jacqueline Wagner's NPI number?

The NPI number for Jacqueline Wagner is 1447598362. It was assigned to this individual provider in the NPPES registry on January 28, 2013. The provider is also known as Jacqueline Lee Cruz-Aedo.

Where is Jacqueline Wagner located?

Jacqueline Wagner practices at 1713 E Sherman Ave, Coeur D Alene, ID 83814. The listed phone number is (208) 966-4087.

What is Jacqueline Wagner's specialty?

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

Is Jacqueline Wagner enrolled in Medicare?

Yes. Jacqueline 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.

What insurance does Jacqueline Wagner accept?

Health plans from PacificSource Health Plans and Premera Blue Cross Blue Shield of Alaska list Jacqueline Wagner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jacqueline Wagner affiliated with any hospitals?

According to CMS data, Jacqueline Wagner is affiliated with Northwest Specialty Hospital.

When was this NPI record last updated?

The NPPES record for Jacqueline Wagner was last updated on August 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.