MS. SUSAN KATALI WAGNER PA-C
NPI 1457544983
Physician Assistant - Medical in Riverside, CA

Q: What is Susan Wagner's NPI number?

The NPI number for Susan Wagner is 1457544983. It was assigned to this individual provider in the NPPES registry on August 17, 2007. The provider is also known as Ms. Susan Katali Wagabaza Pa-C.

Q: What is Susan Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Susan Wagner was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 August 17, 2007PECOS Enrolled

6926 BROCKTON AVE, STE 9, RIVERSIDE, CA 92506(951) 788-0370(951) 788-0390 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ms. Susan Katali Wagner Pa-c NPPES

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

MS. SUSAN KATALI WAGNER PA-C (NPI 1457544983) is an individual medical provider in Riverside, California, licensed in California (PA16194) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457544983

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. SUSAN KATALI WAGNERCredential: PA-C

Location Address6926 BROCKTON AVE, STE 9Riverside, CA 92506-3800

Mailing Address26610 Kalmia AveMoreno Valley, CA 92555-1727 · (951) 601-3814

Phone(951) 788-0370

Fax(951) 788-0390

Sole ProprietorNo

Enumeration DateAugust 17, 2007

Last NPPES UpdateMarch 7, 2023

✔ NPI 1457544983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA16194

Also ListedRespiratory Therapist, Certified · General CareTaxonomy 2278G1100X · License RCP19999 (CA)

6926 BROCKTON AVE, Riverside, CA 92506

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Other Names 1

Other Name (5)Ms. Susan Katali Wagabaza Pa-c

Other Identifiers 2

OtherPA16194CA · State

Other1034312GA · Nccpa

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Susan Katali 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 9

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

HUBERT CHARLES WATKINS MD

Dermatology

6926 BROCKTON AVE, SUITE 10
RIVERSIDE, CA 92506

Riverside County (951) 683-0540

HERMAN A CARSTENS MD CLINIC OF OBSTETRICS AND GYNECOLOGY P C

Obstetrics & Gynecology

6926 BROCKTON AVE, SUITE 7
RIVERSIDE, CA 92506

Riverside County (951) 686-8600

DR. EDILBERTO LUMELAY AGAS JR. M.D.

Pediatrics

6926 BROCKTON AVE, SUITE 6
RIVERSIDE, CA 92506

Riverside County (951) 779-1670

KATHRYN RACHEL PORTER PA-C

Pediatrics

6926 BROCKTON AVE
RIVERSIDE, CA 92506

Riverside County (616) 826-9762

NEGEEN ZAREH D M D INC A PROFESSIONAL CORPORATION

Dentist (General Practice)

6926 BROCKTON AVE, SUITE 3
RIVERSIDE, CA 92506

Riverside County (951) 784-7123

MR. TRACY SCOTT MACCALLUM LMT

Specialist

6926 BROCKTON AVE, #8
RIVERSIDE, CA 92506

Riverside County (951) 347-5179

MR. NARESH KUMAR SHARMA MD

Orthopaedic Surgery

6926 BROCKTON AVE, SUITE 11
RIVERSIDE, CA 92506

Riverside County (800) 240-8657

LAUREN SEASTROM HUNT N.P.

Nurse Practitioner (Pediatrics)

6926 BROCKTON AVE, SUITE 6
RIVERSIDE, CA 92506

Riverside County (951) 779-1670

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 Susan Wagner's NPI number?

The NPI number for Susan Wagner is 1457544983. It was assigned to this individual provider in the NPPES registry on August 17, 2007. The provider is also known as Ms. Susan Katali Wagabaza Pa-C.

Where is Susan Wagner located?

Susan Wagner practices at 6926 Brockton Ave Ste 9, Riverside, CA 92506. The listed phone number is (951) 788-0370.

What is Susan Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Susan Wagner enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Susan Wagner was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.