Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AVERY FAITH WAGNER
NPI 1598639130
Nurse Practitioner - Family in San Antonio, TX

Q: What is Avery Wagner's NPI number?

The NPI number for Avery Wagner is 1598639130. It was assigned to this individual provider in the NPPES registry on October 4, 2025.

Q: What is Avery Wagner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Avery Wagner was last updated on September 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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 October 04, 2025PECOS Enrolled

502 MADISON OAK DR STE 310, SAN ANTONIO, TX 78258(210) 483-8883(210) 494-1740 Get Directions Write a Review

NPPES record last updated: September 25, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 25, 2026, Aug 15, 2026 (2 updates tracked since 2026).

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About Avery Faith Wagner NPPES

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

AVERY FAITH WAGNER (NPI 1598639130) is an individual family provider in San Antonio, Texas, licensed in Texas (1102505) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1598639130

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAVERY FAITH WAGNER

Location Address502 MADISON OAK DR STE 310San Antonio, TX 78258-4298

Mailing Address757 Greenway TrlNew Braunfels, TX 78132-0103 · (512) 887-0264

Phone(210) 483-8883

Fax(210) 494-1740

Sole ProprietorYes

Enumeration DateOctober 4, 2025

Last NPPES UpdateSeptember 25, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 25, 2026

✔ NPI 1598639130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · 1102505

502 MADISON OAK DR STE 310, San Antonio, TX 78258

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avery Faith Wagner 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78258 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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 6

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

LILY BATES

Internal Medicine (Cardiovascular Disease)