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

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: August 02, 2026.

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
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

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, and ordering and referring status from the CMS PECOS system.

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.

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

Hospital Affiliations CMS Care Compare 3

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

Corning Hospital

Acute Care Hospitals · Corning, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330277
Location1 Guthrie DriveCorning, NY 14830 · Steuben 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
Quality92.36
Improvement Activities40

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.

Radiology (Diagnostic Radiology)
1800 RENAISSANCE BLVD STE 110
EDMOND, OK 73013

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.

Is Derrick Wagoner affiliated with any hospitals?

According to CMS data, Derrick Wagoner is affiliated with Arnot Ogden Medical Center, Corning Hospital 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 11 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.