DR. KEITH DINEEN WAGNER M.D.
NPI 1760047112
Dermatology in Appleton, WI

Q: What is Keith Wagner's NPI number?

The NPI number for Keith Wagner is 1760047112. It was assigned to this individual provider in the NPPES registry on May 1, 2019.

Q: What is Keith Wagner's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Wagner was last updated on September 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 01, 2019PECOS EnrolledAccepts Medicare Assignment

3935 N LIGHTNING DR, APPLETON, WI 54913(920) 968-1790(920) 968-1794 Get Directions Write a Review

NPPES record last updated: September 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 19, 2023, May 1, 2019 (2 updates tracked since 2019).

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About Dr. Keith Dineen Wagner M.d. NPPES

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

DR. KEITH DINEEN WAGNER M.D. (NPI 1760047112) is an individual dermatology provider in Appleton, Wisconsin, licensed in Wisconsin (82425-20) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Kaukauna, and is a graduate of University Of Texas Medical Branch At Galveston (2015).

NPPES Registry Identity

NPI1760047112

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameDR. KEITH DINEEN WAGNERCredential: M.D.

Location Address3935 N LIGHTNING DRAppleton, WI 54913-6717

Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008

Phone(920) 968-1790

Fax(920) 968-1794

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2015

Enumeration DateMay 1, 2019

Last NPPES UpdateSeptember 11, 20232 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2023

✔ NPI 1760047112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in WI · 82425-20

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

3935 N LIGHTNING DR, Appleton, WI 54913

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Secondary Practice Location 1

Location 12700 Crooks Ave Ste 101Kaukauna, WI 54130-3900 · Phone (920) 581-5561 · Fax (920) 785-5511

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

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. Keith Dineen Wagner 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 ID3971965567

PECOS Enrollment IDI20230814003291

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 18

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

538 services117 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

315 services248 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

190 services159 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

143 services126 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

95 services95 patients

Therapy procedure using ultraviolet radiation with tar or petroleum jelly application 96910

This therapy involves applying tar or petroleum jelly on the skin, followed by exposure to ultraviolet radiation. It helps in treating skin conditions by slowing cell growth and reducing inflammation. It's a safe, controlled process, often used for conditions like psoriasis.

91 services13 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

90 services84 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

67 services55 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

53 services28 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

36 services29 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

19 services19 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

15 services15 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

13 services12 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

13 services12 patients

All potassium hydroxide (koh) preparations Q0112

Potassium hydroxide (KOH) preparations are used in medical testing to identify fungal infections. In this procedure, a sample (like skin, hair, or nail) is collected and treated with KOH solution. This destroys non-fungal cells, making it easier to spot fungi under a microscope.

13 services12 patients

Injection into skin growth, 1-7 growths 11900

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

12 services11 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54913 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

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 4

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

HILLARY MARIE AHOLA-JACQUES PA-C, MPAS

Physician Assistant

3935 N LIGHTNING DR
APPLETON, WI 54913

Outagamie County (920) 968-1790

FOREFRONT DERMATOLOGY, S.C.

Dermatology

3935 N LIGHTNING DR
APPLETON, WI 54913

Outagamie County (920) 968-1790

DR. PETER J KATZ MD

Dermatology

3935 N LIGHTNING DR
APPLETON, WI 54913

Outagamie County (920) 968-1790

NOAH ROBERT SMITH MD

Dermatology

3935 N LIGHTNING DR
APPLETON, WI 54913

Outagamie County (920) 968-1790

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 Keith Wagner's NPI number?

The NPI number for Keith Wagner is 1760047112. It was assigned to this individual provider in the NPPES registry on May 1, 2019.

Where is Keith Wagner located?

Keith Wagner practices at 3935 N Lightning Dr, Appleton, WI 54913. The listed phone number is (920) 968-1790.

What is Keith Wagner's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Keith Wagner enrolled in Medicare?

Yes. Keith Wagner 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.

What insurance does Keith Wagner accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 3 other insurers list Keith Wagner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keith Wagner was last updated on September 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.