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DR. MICHAEL DALE WAGNER PHD
NPI 1760577340
Psychologist - Clinical in Westerville, OH

Active since October 03, 2006PECOS Enrolled
5415 MEDALLION DR W, WESTERVILLE, OH 43082(614) 218-8769 Get Directions Write a Review

NPPES record last updated: June 20, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 20, 2020, Jun 8, 2020, Jan 14, 2019 and 1 more (4 updates tracked since 2019).

About Dr. Michael Dale Wagner Phd NPPES

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

DR. MICHAEL DALE WAGNER PHD (NPI 1760577340) is an individual clinical provider in Westerville, Ohio, licensed in Ohio (4636) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760577340
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MICHAEL DALE WAGNERCredential: PHD
Location Address5415 MEDALLION DR WWesterville, OH 43082-9194
Mailing Address5415 Medallion Dr WWesterville, OH 43082-9194 · (614) 218-8769
Phone(614) 218-8769
Sole ProprietorYes
Enumeration DateOctober 3, 2006
Last NPPES UpdateJune 20, 20204 updates tracked since enumeration
NPPES CertifiedJune 20, 2020
✔ NPI 1760577340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in OH · 4636
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License 4636 (OH)
5415 MEDALLION DR W, Westerville, OH 43082
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., CareSource and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael Dale Wagner Phd 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 Reassignment

Medicare enrollment records show Michael Wagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mt. Airy Development, LLC
112 mi
Psychiatric Hospital
2446 KIPLING AVE
Cincinnati, OH 45239
  • Reassigned Medicare billing, Ohio enrollment
  • 13 clinicians in this Medicare group
NPI 1801405519 (513) 993-6211

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43082 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Michael Wagner's NPI number?

The NPI number for Michael Wagner is 1760577340. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Michael Wagner located?

Michael Wagner practices at 5415 Medallion Dr W, Westerville, OH 43082. The listed phone number is (614) 218-8769.

What is Michael Wagner's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Michael Wagner enrolled in Medicare?

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

Which organization bills Medicare for Michael Wagner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Wagner reassigns Medicare benefits to Mt. Airy Development, LLC (Cincinnati, OH). The 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 Michael Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Wagner accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., CareSource, MedMutual and Oscar Health Insurance and 2 other insurers list Michael 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 Michael Wagner was last updated on June 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.