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JOHN EDWARD WAGNER LSW
NPI 1649813973
Social Worker in Clifton, NJ

Active since October 18, 2019PECOS Enrolled
53 ORCHARD ST, CLIFTON, NJ 07013(973) 773-7600(973) 773-7011 Get Directions Write a Review

NPPES record last updated: October 18, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About John Edward Wagner Lsw NPPES

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

JOHN EDWARD WAGNER LSW (NPI 1649813973) is an individual social worker in Clifton, New Jersey, licensed in New Jersey (44SL06420400) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649813973
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameJOHN EDWARD WAGNERCredential: LSW
Location Address53 ORCHARD STClifton, NJ 07013-1832
Mailing Address53 Orchard StClifton, NJ 07013-1832 · (973) 773-7600 · Fax (973) 773-7011
Phone(973) 773-7600
Fax(973) 773-7011
Sole ProprietorYes
Enumeration DateOctober 18, 2019
✔ NPI 1649813973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NJ · 44SL06420400
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
53 ORCHARD ST, Clifton, NJ 07013
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Edward Wagner Lsw 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 Reassignments

2

Medicare enrollment records show John Wagner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychiatry On Video LLC
8.1 mi
Psychiatry
162 E RIDGEWOOD AVE
Ridgewood, NJ 07450
  • Reassigned Medicare billing, New Jersey enrollment
  • 11 clinicians in this Medicare group
NPI 1700532587 (201) 470-4006
Premier Psychiatric Consultants LLC
8.9 mi
Adult Mental Health
6000 WASHINGTON ST
West New York, NJ 07093
  • Reassigned Medicare billing, New Jersey enrollment
  • 10 clinicians in this Medicare group
NPI 1508182072 (201) 864-4897

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

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.

ANGELA GRACEFFO LCSW
Social Worker (Clinical)
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
KAITLYN MARIE GALINDO LAC
Counselor (Mental Health)
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
ADULT FAMILY HEALTH SERVICES LLC
Counselor (Mental Health)
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
SIENNA MARESE
Counselor (Addiction (Substance Use Disorder))
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
FOUNDATION FOR ADULT FAMILY HEALTH CARE SERVICES
Social Worker
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
ERIC TRACY LAC
Counselor (Mental Health)
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
CONNOR THOMAS HAMMALIAN
Counselor
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600
CHRYSA LAWSON LSW
Social Worker
53 ORCHARD ST
CLIFTON, NJ 07013
Passaic County (973) 773-7600

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 John Wagner's NPI number?

The NPI number for John Wagner is 1649813973. It was assigned to this individual provider in the NPPES registry on October 18, 2019.

Where is John Wagner located?

John Wagner practices at 53 Orchard St, Clifton, NJ 07013. The listed phone number is (973) 773-7600.

What is John Wagner's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is John Wagner enrolled in Medicare?

Yes. John Wagner is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for John Wagner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Wagner reassigns Medicare benefits to 2 organizations: Psychiatry On Video LLC (Ridgewood, NJ) and Premier Psychiatric Consultants LLC (West New York, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Wagner was last updated on October 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.