KRISTEN M WAGNER D.O.
NPI 1598017048
Family Medicine in Fruitport, MI
About Kristen M Wagner D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRISTEN M WAGNER D.O. (NPI 1598017048) is an individual family medicine provider in Fruitport, Michigan, licensed in Michigan (5101020125) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kristen M Wagner D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49415 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
FRUITPORT, MI 49415
FRUITPORT, MI 49415
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 Kristen Wagner's NPI number?
The NPI number for Kristen Wagner is 1598017048. It was assigned to this individual provider in the NPPES registry on October 9, 2012.
Where is Kristen Wagner located?
Kristen Wagner practices at 3443 Farr Rd, Fruitport, MI 49415. The listed phone number is (231) 672-2900.
What is Kristen Wagner's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kristen Wagner enrolled in Medicare?
Yes. Kristen Wagner is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kristen Wagner was last updated on December 23, 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.
# Kristen M Wagner, D.O. · NPI 1598017048
Family Medicine physician in Fruitport, Michigan. Individual provider, active in the CMS NPPES registry since October 9, 2012.
## Identity
- **NPI:** 1598017048 (Entity type: Individual)
- **Enumerated:** October 9, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 5101020125 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3443 FARR RD, Fruitport, MI 49415-8779
- **Phone:** (231) 672-2900 · **Fax:** (231) 672-2901
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 23, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1598017048) · Data from the CMS NPPES public registry.