DR. JACKSON WAGONER MD
NPI 1689137408
Anesthesiology - Pain Medicine in Casper, WY


Quality Rating: 97.64 out of 100 score

NPI Status: Active since April 09, 2019

Contact Information

1541 DIAMOND DR
CASPER, WY
ZIP 82601
Phone: (307) 439-1097

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  • Individual
  • Male
  • Years of Experience 7
  • Anesthesiology
  • Pain Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JACKSON WAGONER

This page provides the complete NPI Profile along with additional information for Jackson Wagoner, a provider established in Casper, Wyoming with a medical specialization in Anesthesiology, focusing in pain medicine and more than 7 years of experience. He graduated from University Of Nebraska College Of Medicine in 2019. The healthcare provider is registered in the NPI registry with number 1689137408 assigned on April 2019. The practitioner's primary taxonomy code is 207LP2900X with license number 19414A (WY). The provider is registered as an individual and his NPI record was last updated April 2026.

NPI
1689137408
Provider Name
DR. JACKSON WAGONER MD
Gender
Male
Entity Type
Individual
Location Address
1541 DIAMOND DR CASPER, WY 82601
Location Phone
(307) 439-1097
Mailing Address
PO BOX 100254 GAINESVILLE, FL 32610
Mailing Phone
(352) 273-8610
Mailing Fax
Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year
2019
Is Sole Proprietor?
No
Enumeration Date
04-09-2019
Last Update Date
04-08-2026
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Location Map

Secondary Locations

  • 1600 SW Archer Rd
    Gainesville, FL 32610
    (352) 273-8610
  • 1501 N Campbell Ave Rm 4401
    Tucson, AZ 85724
    (520) 626-7721
  • 2600 Sixth St SW
    Canton, OH 44710
    (330) 452-9911

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
License No.
19414A
License State
WY
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

69349 (AZ)
2207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

ME169309 (FL)
3207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

ME169309 (FL)

Medicare Participation & PECOS Enrollment Status

Jackson Wagoner is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jackson Wagoner is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6305269382

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20260219002020

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.64, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 97.64 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 84.77

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 98.67

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jackson Wagoner is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SAGEWEST HEALTH CARE2100 W SUNSET DR
RIVERTON, WY 82501
(307) 856-4161Acute Care Hospitals
SUMMIT MEDICAL CENTER6350 E 2ND STREET
CASPER, WY 82609
(307) 232-6600Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1689137408, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
9
Unchanged
Pos 5
1
Doubled → 2
Pos 6
3
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 1 → 2 7 → 14 → 5 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 6 + 9 + 2 + 3 + 1 + 4 + 4 + 0 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1689137408.

Other Providers at the Same Location


The following 11 providers are registered at the same or a nearby location.

Physical Therapist
1541 DIAMOND DR
CASPER, WY 82601
Counselor (Mental Health)
1541 DIAMOND DR
CASPER, WY 82601
Community/Behavioral Health
1541 DIAMOND DR
CASPER, WY 82601
Social Worker (Clinical)
1541 DIAMOND DR
CASPER, WY 82601
Physical Medicine & Rehabilitation
1541 DIAMOND DR
CASPER, WY 82601
Advanced Practice Midwife
1541 DIAMOND DR
CASPER, WY 82601
Psychiatry & Neurology (Psychiatry)
1541 DIAMOND DR
CASPER, WY 82601
Psychiatry & Neurology (Psychiatry)
1541 DIAMOND DR
CASPER, WY 82601
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
1541 DIAMOND DR
CASPER, WY 82601
Durable Medical Equipment & Medical Supplies
1541 DIAMOND DR
CASPER, WY 82601
Anesthesiology (Pain Medicine)
1541 DIAMOND DR
CASPER, WY 82601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689137408, enumerated as an "individual" on April 09, 2019.

The provider is located at 1541 DIAMOND DR CASPER, WY 82601 and the phone number is (307) 439-1097.

Anesthesiology with taxonomy code 207LP2900X and a focus in Pain Medicine.

Jackson Wagoner is affiliated with: SAGEWEST HEALTH CARE and SUMMIT MEDICAL CENTER.