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

Q: 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.

Q: What is Serena Wagoner's specialty?

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

Q: 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 5 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 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: November 08, 2026.

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

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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 and is a graduate of Other (2020).

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

Medical School CMSOtherGraduated 2020

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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Group Health Cooperative-SCW, HealthPartners, Quartz.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Serena Wagoner Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779943196

PECOS Enrollment IDI20260622000108

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 Serena Wagoner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Wisconsin Medical Foundation, Inc

43 mi

Multi-Specialty

7974 UW HEALTH COURT
Middleton, WI 53562

Reassigned Medicare billing, Wisconsin enrollment
2,832 clinicians in this Medicare group

NPI 1598784555 (608) 829-5485

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

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.

Which organization bills Medicare for Serena Wagoner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Serena Wagoner reassigns Medicare benefits to University Of Wisconsin Medical Foundation, Inc (Middleton, WI). 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 Serena Wagoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Serena Wagoner accept?

Health plans from Group Health Cooperative-SCW, HealthPartners and Quartz list Serena Wagoner 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 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 5 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.