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SERENA WAGONER DO
NPI 1790314854
Pediatrics - Child Abuse Pediatrics in Beaver Dam, WI

Active since April 02, 2020PECOS Enrolled
705 S UNIVERSITY AVE, BEAVER DAM, WI 53916(920) 887-9272 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2026, Jul 7, 2023, Apr 2, 2020 (3 updates tracked since 2020).

About Serena Wagoner Do NPPES

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

SERENA WAGONER DO (NPI 1790314854) is an individual child abuse pediatrics provider in Beaver Dam, Wisconsin, licensed in Wisconsin (82110) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790314854
Entity TypeIndividualFemale
Primary Taxonomy2080C0008X
Provider Legal NameSERENA WAGONERCredential: DO
Location Address705 S UNIVERSITY AVEBeaver Dam, WI 53916-3053
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Phone(920) 887-9272
Sole ProprietorYes
Enumeration DateApril 2, 2020
Last NPPES UpdateJune 1, 20263 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
✔ NPI 1790314854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Child Abuse PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080C0008X
License✔ Licensed in WI · 82110
Definition
A Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agencies on child safety; providing expertise in courts of law; treating consequences of abuse and neglect; directing child abuse and neglect prevention programs and participating on multidisciplinary teams investigating; and managing child abuse cases.
705 S UNIVERSITY AVE, Beaver Dam, WI 53916
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Serena Wagoner Do 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.

Other Providers at the Same Location NPPES 20

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

GEORGE E DAVIS MD
Ophthalmology
705 S UNIVERSITY AVE, SUITE 100
BEAVER DAM, WI 53916
Dodge County (920) 887-1151
DEAN HEALTH SYSTEMS, INC.
Durable Medical Equipment & Medical Supplies
705 S UNIVERSITY AVE, STE 500
BEAVER DAM, WI 53916
Dodge County (920) 887-3102
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Durable Medical Equipment & Medical Supplies
705 S UNIVERSITY AVE, SUITE 200
BEAVER DAM, WI 53916
Dodge County (920) 887-9272
DR. WILLIAM HENRY BULL V MD
Internal Medicine
705 S UNIVERSITY AVE
BEAVER DAM, WI 53916
Dodge County (920) 887-9272
MARSHLAND PHARMACIES INC
Pharmacy (Community/Retail Pharmacy)
705 S UNIVERSITY AVE
BEAVER DAM, WI 53916
Dodge County (920) 356-0040
LYNN R SWIGGUM A.T.C., L.A.T.
Specialist
705 S UNIVERSITY AVE, SUITE 150
BEAVER DAM, WI 53916
Dodge County (920) 885-2663
SUSAN LORRAINE SUTTER R.PH.
Pharmacist
705 S UNIVERSITY AVE, SUITE 180
BEAVER DAM, WI 53916
Dodge County (920) 356-0040
WILSON H LUY TAN, MD LTD
Psychiatry & Neurology (Neurology)
705 S UNIVERSITY AVE, SUITE 380
BEAVER DAM, WI 53916
Dodge County (920) 887-3460

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 Serena Wagoner's NPI number?

The NPI number for Serena Wagoner is 1790314854. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Where is Serena Wagoner located?

Serena Wagoner practices at 705 S University Ave, Beaver Dam, WI 53916. The listed phone number is (920) 887-9272.

What is Serena Wagoner's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Child Abuse Pediatrics, with taxonomy code 2080C0008X.

Is Serena Wagoner enrolled in Medicare?

Yes. Serena Wagoner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Serena Wagoner was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.