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DR. JACK WAGONER M.D.
NPI 1598700072
Anesthesiology in Jackson, MI

Active since June 18, 2006PECOS EnrolledAccepts Medicare Assignment
83.28/100
CMS Quality Rating
205 N EAST AVE, JACKSON, MI 49201(517) 788-4963(517) 789-5903 Get Directions Write a Review

NPPES record last updated: November 6, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack Wagoner M.d. NPPES

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

DR. JACK WAGONER M.D. (NPI 1598700072) is an individual anesthesiology provider in Jackson, Michigan, licensed in Michigan (4301-407025) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Michigan Health System, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1598700072
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameDR. JACK WAGONERCredential: M.D.
Location Address205 N EAST AVEJackson, MI 49201-1753
Mailing Address205 N East AveJackson, MI 49201-1753 · (517) 788-4963 · Fax (517) 789-5903
Phone(517) 788-4963
Fax(517) 789-5903
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateJune 18, 2006
Last NPPES UpdateNovember 6, 2007
✔ NPI 1598700072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in MI · 4301-407025
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
205 N EAST AVE, Jackson, MI 49201
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type UnspecifiedOC86047-007MI
Medicaid2737106MI
Medicare UPINF32633

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Wagoner M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608868435
PECOS Enrollment IDI20100625000709
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
178 services145 patients
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
12 services12 patients
Anesthesia for procedure on stomach for weight loss 00797
Anesthesia for a weight loss procedure on the stomach ensures you're comfortable and pain-free during surgery. It can be general (you're asleep) or regional (you're awake but numb). It's administered by a specialist who monitors your vital signs throughout the procedure.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Michigan Health System

Acute Care Hospitals · Ann Arbor, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230046
Location1500 E Medical Center Drive, Spc 5474Ann Arbor, MI 48109 · Washtenaw County
Emergency services Birthing friendly

Forest Health Medical Center

Acute Care Hospitals · Ypsilanti, MI
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230144
Location135 S Prospect StYpsilanti, MI 48198 · Washtenaw County

Chelsea Hospital

Acute Care Hospitals · Chelsea, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230259
Location775 S Main StChelsea, MI 48118 · Washtenaw County
Emergency services

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.

83.28/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.98
Improvement Activities40
Cost68.13

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.

SAMANTHA RENE DANEK PA-C
Physician Assistant
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 788-4811
TERRI LYNN LADWIG ACNP-BC
Nurse Practitioner (Acute Care)
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 205-4800
SAMANTHA MISHRA DO
Student in an Organized Health Care Education/Training Program
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 788-4800
JOSHUA BOOTH CRNA
Nurse Anesthetist, Certified Registered
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 205-4800
NADINE BALLOUT MD
Anesthesiology
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 205-4730
MICHELLE WINTERS
Specialist/Technologist (Athletic Trainer)
205 N EAST AVE
JACKSON, MI 49201
Jackson County (517) 205-4800
NINA MARIE BOCK PA-C
Physician Assistant
205 N EAST AVE
JACKSON, MI 49201
Jackson County (248) 990-5924
MRS. CHRISTINE HUFF RDN
Dietitian, Registered
205 N EAST AVE, FOOTE HOSPITAL, NUTRITION SERVICES DEPT.
JACKSON, MI 49201
Jackson County (517) 768-7793

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 Jack Wagoner's NPI number?

The NPI number for Jack Wagoner is 1598700072. It was assigned to this individual provider in the NPPES registry on June 18, 2006.

Where is Jack Wagoner located?

Jack Wagoner practices at 205 N East Ave, Jackson, MI 49201. The listed phone number is (517) 788-4963.

What is Jack Wagoner's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Jack Wagoner enrolled in Medicare?

Yes. Jack Wagoner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jack Wagoner affiliated with any hospitals?

According to CMS data, Jack Wagoner is affiliated with University Of Michigan Health System, Forest Health Medical Center and Chelsea Hospital.

When was this NPI record last updated?

The NPPES record for Jack Wagoner was last updated on November 6, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.