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JON-ERIK WAGNER M.D.
NPI 1619303104
Student in an Organized Health Care Education/Training Program in Johnson City, NY

Active since September 17, 2013PECOS Enrolled
40 ARCH ST, JOHNSON CITY, NY 13790(607) 763-6075(607) 763-5234 Get Directions Write a Review

NPPES record last updated: January 21, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jon-erik Wagner M.d. NPPES

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

JON-ERIK WAGNER M.D. (NPI 1619303104) is an individual student in an organized health care education/training program in Johnson City, New York and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619303104
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJON-ERIK WAGNERCredential: M.D.
Location Address40 ARCH STJohnson City, NY 13790-2102
Mailing Address346 Grand AveJohnson City, NY 13790-2580 · (607) 763-6075 · Fax (607) 763-5234
Phone(607) 763-6075
Fax(607) 763-5234
Sole ProprietorNo
Enumeration DateSeptember 17, 2013
Last NPPES UpdateJanuary 21, 2014
✔ NPI 1619303104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
40 ARCH ST, Johnson City, NY 13790
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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)

Jon-erik Wagner M.d. 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.

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.

JULIE DOUGLASS
Dietitian, Registered
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6092
DR. PERIKA SHAUGN DEROCHE MD
Student in an Organized Health Care Education/Training Program
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6075
CHRISTINE WOZNIAK RD
Dietitian, Registered
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6075
OLAYINKA O WILHELM MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
40 ARCH ST, DIABETES CENTER - PICCIANO 2
JOHNSON CITY, NY 13790
Broome County (607) 763-6092
JILLENE MYRNELLE BRATHWAITE D.O.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6092
TYSON DON BRIERLEY D.O.
Family Medicine
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6075
DR. AHMED FAISAL CHOWDHURY MD
Student in an Organized Health Care Education/Training Program
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6075
KATHERINE HOLMES MD
Family Medicine
40 ARCH ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6075

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 Jon-erik Wagner's NPI number?

The NPI number for Jon-erik Wagner is 1619303104. It was assigned to this individual provider in the NPPES registry on September 17, 2013.

Where is Jon-erik Wagner located?

Jon-erik Wagner practices at 40 Arch St, Johnson City, NY 13790. The listed phone number is (607) 763-6075.

What is Jon-erik Wagner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jon-erik Wagner enrolled in Medicare?

Yes. Jon-erik Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jon-erik Wagner was last updated on January 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.