DR. AMY CLAIRE WAGNER PH.D., L.M.F.T.
NPI 1568516698
Psychologist - Clinical in Wilmette, IL

Q: What is Amy Wagner's NPI number?

The NPI number for Amy Wagner is 1568516698. It was assigned to this individual provider in the NPPES registry on January 23, 2007.

Q: What is Amy Wagner's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Amy Wagner enrolled in Medicare?

No. Amy Wagner has opted out of Medicare through October 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Amy Wagner was last updated on August 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 23, 2007Opted out of Medicare · through Oct 16, 2027

104 CENTRAL PARK AVE, WILMETTE, IL 60091(847) 721-0965 Get Directions Write a Review

NPPES record last updated: August 7, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Amy Claire Wagner Ph.d., L.m.f.t. NPPES

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

DR. AMY CLAIRE WAGNER PH.D., L.M.F.T. (NPI 1568516698) is an individual clinical provider in Wilmette, Illinois, licensed in Illinois (071003893) and active in the NPI registry since January 2007. She has opted out of Medicare through October 16, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1568516698

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. AMY CLAIRE WAGNERCredential: PH.D., L.M.F.T.

Location Address104 CENTRAL PARK AVEWilmette, IL 60091-3202

Mailing Address104 Central Park AveWilmette, IL 60091-3202 · (847) 721-0965

Phone(847) 721-0965

Sole ProprietorYes

Enumeration DateJanuary 23, 2007

Last NPPES UpdateAugust 7, 2020

NPPES CertifiedAugust 7, 2020

✔ NPI 1568516698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071003893

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

104 CENTRAL PARK AVE, Wilmette, IL 60091

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Amy Claire Wagner Ph.d., L.m.f.t. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 16, 2019 through October 16, 2027.

Opt-Out Effective DateOctober 16, 2019

Opt-Out In Effect ThroughOctober 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60091 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

$183.39 typical visit price

range $60.08 – $183.39

Typical copayment $45.84 (range $15.02 – $45.84)

Most-billed visit code 99205

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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.

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 Amy Wagner's NPI number?

The NPI number for Amy Wagner is 1568516698. It was assigned to this individual provider in the NPPES registry on January 23, 2007.

Where is Amy Wagner located?

Amy Wagner practices at 104 Central Park Ave, Wilmette, IL 60091. The listed phone number is (847) 721-0965.

What is Amy Wagner's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Amy Wagner enrolled in Medicare?

No. Amy Wagner has opted out of Medicare through October 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Amy Wagner was last updated on August 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.