RICHARD W WAGONER M.D.
NPI 1861458952
Internal Medicine in Havana, IL

Q: What is Richard Wagoner's NPI number?

The NPI number for Richard Wagoner is 1861458952. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Q: What is Richard Wagoner's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Wagoner was last updated on June 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 April 26, 2006PECOS EnrolledAccepts Medicare Assignment

95.01/100

CMS Quality Rating

615 N PROMENADE ST, HAVANA, IL 62644(309) 543-6600(309) 543-2089 Get Directions Write a Review

NPPES record last updated: June 1, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Richard W Wagoner M.d. NPPES

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

RICHARD W WAGONER M.D. (NPI 1861458952) is an individual internal medicine provider in Havana, Illinois, licensed in Illinois (036104579) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1861458952

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameRICHARD W WAGONERCredential: M.D.

Location Address615 N PROMENADE STHavana, IL 62644-1243

Mailing Address615 N Promenade St, P O Box 530Havana, IL 62644-1015 · (309) 543-6600 · Fax (309) 543-2089

Phone(309) 543-6600

Fax(309) 543-2089

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateApril 26, 2006

Last NPPES UpdateJune 1, 2012

✔ NPI 1861458952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036104579

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

615 N PROMENADE ST, Havana, IL 62644

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Other Identifiers 3

Medicare ID-Type Unspecified808700IL · Peds

Medicaid036104579IL

Medicare UPINH43126IL

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

Richard W Wagoner M.d. 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 ID7416085675

PECOS Enrollment IDI20100507000571

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

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.

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

20 services20 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Mason District Hospital

Critical Access Hospitals · Havana, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141313

Location615 North Promenade Street,p O Box 530Havana, IL 62644 · Mason County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62644 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

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.

95.01/100

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

Scored through an Alternative Payment Model

Quality

80.02

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers33 claims73 services$6.42 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

4 suppliers13 claims16 services$1.14 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers15 claims15 services$39.05 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

3 suppliers15 claims41 services$17.41 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers21 claims22 services$65.69 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers23 claims23 services$21.81 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. CARLOS ALBERTO URDININEA KIRKWOOD M.D.

Internal Medicine