DR. TRACIE DENIE JOHNSON-WAGNER PMHNP-BC
NPI 1578064382
Nurse Practitioner - Psychiatric/Mental Health in Phoenix, AZ

Q: What is Tracie Johnson-wagner's NPI number?

The NPI number for Tracie Johnson-wagner is 1578064382. It was assigned to this individual provider in the NPPES registry on February 27, 2018.

Q: What is Tracie Johnson-wagner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since February 27, 2018PECOS Enrolled

7330 N 16TH ST STE C115, PHOENIX, AZ 85020(646) 941-7645(929) 596-7897 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 2, 2024, Oct 25, 2023, Jun 23, 2023 and 2 more (5 updates tracked since 2018).

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About Dr. Tracie Denie Johnson-wagner Pmhnp-bc NPPES

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

DR. TRACIE DENIE JOHNSON-WAGNER PMHNP-BC (NPI 1578064382) is an individual psychiatric/mental health provider in Phoenix, Arizona, licensed in Arizona (AP11024) and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578064382

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameDR. TRACIE DENIE JOHNSON-WAGNERCredential: PMHNP-BC

Location Address7330 N 16TH ST STE C115Phoenix, AZ 85020-8209

Mailing Address7330 N 16th St Ste C115Phoenix, AZ 85020-8209

Phone(646) 941-7645

Fax(929) 596-7897

Sole ProprietorNo

Enumeration DateFebruary 27, 2018

Last NPPES UpdateFebruary 23, 20265 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2026

✔ NPI 1578064382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in AZ · AP11024✔ Licensed in CO · C-RXN.0002422-C-NP

7330 N 16TH ST STE C115, Phoenix, AZ 85020

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tracie Denie Johnson-wagner Pmhnp-bc 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.

Medicare Billing Reassignment

Medicare enrollment records show Tracie Johnson-wagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mile High Psychiatry LLC

582 mi

Psychiatric/Mental Health

2675 S ABILENE ST STE 100
Aurora, CO 80014

Reassigned Medicare billing, Colorado enrollment
41 clinicians in this Medicare group

NPI 1407681174 (720) 507-4779

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85020 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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 5

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

BRENNA GONZALES LPC

Counselor (Professional)