DR. DERRICK DURELL WAGONER D.O.
NPI 1760829220
Radiology - Diagnostic Radiology in Edmond, OK

Q: What is Derrick Wagoner's NPI number?

The NPI number for Derrick Wagoner is 1760829220. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Q: What is Derrick Wagoner's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Derrick Wagoner was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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 23, 2013PECOS EnrolledAccepts Medicare Assignment

99.53/100

CMS Quality Rating

1800 RENAISSANCE BLVD STE 110, EDMOND, OK 73013(405) 601-2325 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Derrick Durell Wagoner D.o. NPPES

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

DR. DERRICK DURELL WAGONER D.O. (NPI 1760829220) is an individual diagnostic radiology provider in Edmond, Oklahoma, licensed in Oklahoma (6324) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS, is affiliated with Arnot Ogden Medical Center, and maintains a secondary practice location in Williamsville.

NPPES Registry Identity

NPI1760829220

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. DERRICK DURELL WAGONERCredential: D.O.

Location Address1800 RENAISSANCE BLVD STE 110Edmond, OK 73013

Mailing Address321 Shappee StHorseheads, NY 14845-1918

Phone(405) 601-2325

Sole ProprietorYes

Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2013

Enumeration DateMay 23, 2013

Last NPPES UpdateAugust 29, 2025

NPPES CertifiedAugust 29, 2025

✔ NPI 1760829220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in OK · 6324

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

1800 RENAISSANCE BLVD STE 110, Edmond, OK 73013

Open in Google Maps ↗

Secondary Practice Location 1

Location 1325 Essjay RdWilliamsville, NY 14221-8243 · Phone (716) 630-1000

Other Identifiers 1

Medicaid200769850AOK

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Derrick Durell Wagoner D.o. 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 ID8123383205

PECOS Enrollment IDI20190815003092, I20211005000161

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

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

Associated Radiologists Of The Finger Lakes PC

1,197 mi

Diagnostic Ultrasound

600 ROE AVE
Elmira, NY 14905

Reassigned Medicare billing, New York and Virginia enrollments
8 clinicians in this Medicare group

NPI 1063489060 (607) 734-3414

Gershon Pain Specialists, LLC

1,199 mi

Pain Medicine

1133 FIRST COLONIAL RD
Virginia Beach, VA 23454

Reassigned Medicare billing, Virginia enrollment
12 clinicians in this Medicare group

NPI 1871710798 (757) 496-2050

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

Areas of Expertise CMS Part B claims 45

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.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

238 services213 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

194 services118 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

190 services116 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

119 services108 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

86 services55 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

83 services81 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

77 services49 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance 27096

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

65 services41 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

52 services51 patients

Ct scan of upper spine without contrast 72125

A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.

48 services47 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

47 services30 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

44 services38 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

44 services44 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

39 services37 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

36 services35 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

31 services23 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

31 services31 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

30 services29 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

29 services28 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint 64636

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

28 services23 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

24 services24 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

24 services21 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

23 services18 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

23 services22 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level 64494

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

21 services13 patients

Mri scan of brain without contrast 70551

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

20 services20 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

20 services19 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

20 services20 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

19 services19 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

19 services17 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

18 services18 patients

Ct scan of lower spine without contrast 72131

A CT scan of the lower spine without contrast is a non-invasive imaging test. It uses X-rays to create detailed images of your lower back area, helping to detect conditions like fractures, infections, or tumors. It's painless and generally quick.

18 services18 patients

Low dose ct scan of chest for lung cancer screening 71271

A low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.

17 services17 patients

X-ray of lower and sacral spine, 2-3 views 72100

17 services17 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

16 services15 patients

Fluoroscopic guidance for needle placement 77002

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

15 services12 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

15 services14 patients

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment 77085

A DXA bone density measurement is a non-invasive scan that helps assess the strength of your bones, specifically in the hip, pelvis, and spine areas. It can detect early signs of osteoporosis and evaluate fracture risk. This test uses low-dose X-rays for accurate results.

14 services14 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

13 services13 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

13 services11 patients

Ultrasound scan of head and neck soft tissue 76536

13 services13 patients

Ct scan of blood vessels of neck with contrast 70498

A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.

12 services12 patients

X-ray of chest, 2 views 71046

11 services11 patients

Ct scan of middle spine without contrast 72128

A CT scan of the middle spine without contrast is a non-invasive imaging test. It uses X-rays to create detailed pictures of your mid-spine area. This scan helps doctors identify issues like fractures, tumors, or infections. No dye is used in this procedure.

11 services11 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Arnot Ogden Medical Center

Acute Care Hospitals · Elmira, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330090

Location600 Roe AvenueElmira, NY 14905 · Chemung County

Emergency services Birthing friendly

Cayuga Medical Center At Ithaca

Acute Care Hospitals · Ithaca, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330307

Location101 Dates DriveIthaca, NY 14850 · Tompkins County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73013 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

99.53/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

92.36

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

0%20 patients1/55-star benchmark: 93%

Colorectal Cancer Screening

60%42 patients3/55-star benchmark: 88%

Documentation of Current Medications in the Medical Record

81%64 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

56%25 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

15%55 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%53 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 98% · 44 patients

82%44 patients

Provide Patients Electronic Access to Their Health Information

97%581 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 26 patients

Patients totalRate: 19% · 26 patients

19%26 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

OLIVIER CLERK-LAMALICE MD,MSC

Radiology (Diagnostic Radiology)

1800 RENAISSANCE BLVD STE 110
EDMOND, OK 73013

Oklahoma County (405) 601-2325

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 Derrick Wagoner's NPI number?

The NPI number for Derrick Wagoner is 1760829220. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Where is Derrick Wagoner located?

Derrick Wagoner practices at 1800 Renaissance Blvd Ste 110, Edmond, OK 73013. The listed phone number is (405) 601-2325.

What is Derrick Wagoner's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Derrick Wagoner enrolled in Medicare?

Yes. Derrick Wagoner 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.

Which organizations bill Medicare for Derrick Wagoner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Wagoner reassigns Medicare benefits to 2 organizations: Associated Radiologists Of The Finger Lakes PC (Elmira, NY) and Gershon Pain Specialists, LLC (Virginia Beach, VA). 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 Derrick Wagoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Derrick Wagoner affiliated with any hospitals?

According to CMS data, Derrick Wagoner is affiliated with Arnot Ogden Medical Center and Cayuga Medical Center At Ithaca.

When was this NPI record last updated?

The NPPES record for Derrick Wagoner was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.