JORDAN M WAGNER PA
NPI 1831383074
Family Medicine in Niles, MI

Q: What is Jordan Wagner's NPI number?

The NPI number for Jordan Wagner is 1831383074. It was assigned to this individual provider in the NPPES registry on August 30, 2007. The provider is also known as Jordan M Frizzo.

Q: What is Jordan Wagner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Wagner was last updated on March 14, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since August 30, 2007PECOS EnrolledAccepts Medicare Assignment

2002 S 11TH ST, NILES, MI 49120(269) 687-0200(269) 684-0199 Get Directions Write a Review

NPPES record last updated: March 14, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jordan M Wagner Pa NPPES

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

JORDAN M WAGNER PA (NPI 1831383074) is an individual family medicine provider in Niles, Michigan, licensed in Michigan (5601005116) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Lakeland Hospital, St Joseph, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1831383074

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameJORDAN M WAGNERCredential: PA

Location Address2002 S 11TH STNiles, MI 49120-4074

Mailing Address6416 Deans Hill RdBerrien Center, MI 49102-9750 · (269) 471-7741 · Fax (269) 471-1581

Phone(269) 687-0200

Fax(269) 684-0199

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateAugust 30, 2007

Last NPPES UpdateMarch 14, 2013

✔ NPI 1831383074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 5601005116

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2002 S 11TH ST, Niles, MI 49120

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Other Names 1

Former Name (1)Jordan M Frizzo

Other Identifiers 2

Medicare PINMI2051045MI

Medicaid1831383074MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Jordan M Wagner Pa 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 ID2163518077

PECOS Enrollment IDI20071023000303

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.

Hospital Affiliations CMS Care Compare 2

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

Lakeland Hospital, St Joseph

Acute Care Hospitals · St Joseph, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230021

Location1234 Napier AvenueSt Joseph, MI 49085 · Berrien County

Emergency services Birthing friendly

Corewell Health Watervliet Hospital

Acute Care Hospitals · Watervliet, MI

OwnershipVoluntary non-profit - Private

CMS Certification Number230078

Location400 Medical Park DrWatervliet, MI 49098 · Berrien County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49120 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $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.

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.

MR. CRAIG A. RIGLER M.A. CCC-A AUDIOLOGY

Audiologist