DR. THOMAS RUDOLPH WAGNER M.D.
NPI 1861841488
Internal Medicine - Gastroenterology in Milwaukee, WI

Q: What is Thomas Wagner's NPI number?

The NPI number for Thomas Wagner is 1861841488. It was assigned to this individual provider in the NPPES registry on June 4, 2016.

Q: What is Thomas Wagner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Wagner was last updated on November 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 June 04, 2016PECOS EnrolledAccepts Medicare Assignment

79.61/100

CMS Quality Rating

9200 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 805-2901 Get Directions Write a Review

NPPES record last updated: November 20, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Thomas Rudolph Wagner M.d. NPPES

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

DR. THOMAS RUDOLPH WAGNER M.D. (NPI 1861841488) is an individual gastroenterology provider in Milwaukee, Wisconsin, licensed in Wisconsin (70438-20) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1861841488

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. THOMAS RUDOLPH WAGNERCredential: M.D.

Location Address9200 W WISCONSIN AVEMilwaukee, WI 53226-3522

Mailing Address9200 W Wisconsin AveMilwaukee, WI 53226-3522 · (414) 805-2901

Phone(414) 805-2901

Sole ProprietorYes

Medical School CMSMedical College Of WisconsinGraduated 2016

Enumeration DateJune 4, 2016

Last NPPES UpdateNovember 20, 2019

✔ NPI 1861841488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in WI · 70438-20

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 125.068981 (IL), 70438-20 (WI)

9200 W WISCONSIN AVE, Milwaukee, WI 53226

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Secondary Practice Location 1

Location 15841 S Maryland Ave Ste Mc7082Chicago, IL 60637-1465 · Phone (773) 702-6840 · Fax (773) 702-2230

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Thomas Rudolph Wagner 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 ID8022309699

PECOS Enrollment IDI20220721000643

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

Froedtert South, Inc.

34 mi

Family Medicine

6308 8TH AVE
Kenosha, WI 53143

Reassigned Medicare billing, Wisconsin enrollment
212 clinicians in this Medicare group

NPI 1558305284 (262) 656-2718

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

Areas of Expertise CMS Part B claims 11

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

180 services125 patients

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.

135 services135 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

104 services63 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

101 services96 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

89 services87 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

64 services60 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

60 services47 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

30 services30 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

22 services22 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

11 services11 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

79.61/100

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

Scored as part of a group practice

Quality

70.88

Promoting Interoperability

100

Improvement Activities

Cost

61.15

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.

TRACY BLAIR WANDTKE HERRMANN APNP, CNM

Advanced Practice Midwife

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-4777

DR. ZACHARY SMITH DO

Internal Medicine (Gastroenterology)

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 955-6830

DR. COLLEEN ANN CROWE M.D., M.P.H.

Emergency Medicine

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-6469

ROBERTO MEJIAS APNP

Nurse Practitioner (Pediatrics)

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-6600

MRS. ANNE E B LAKATOS APN-BC, APNP, RN

Nurse Practitioner (Adult Health)

9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-6850

MRS. AMANDA M MANDERS APNP

Nurse Practitioner (Adult Health)

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-6850

KATHLEEN A WATERHOUSE-SKIBICKI CRNA

Nurse Anesthetist, Certified Registered

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Milwaukee County (414) 805-5951

ANDREA L BEQUEST PA

Physician Assistant (Medical)

9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226

Milwaukee County (414) 955-0350

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 Thomas Wagner's NPI number?

The NPI number for Thomas Wagner is 1861841488. It was assigned to this individual provider in the NPPES registry on June 4, 2016.

Where is Thomas Wagner located?

Thomas Wagner practices at 9200 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 805-2901.

What is Thomas Wagner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Thomas Wagner enrolled in Medicare?

Yes. Thomas Wagner 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.

Which organization bills Medicare for Thomas Wagner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Wagner reassigns Medicare benefits to Froedtert South, Inc. (Kenosha, 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 Thomas Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Wagner accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and Network Health list Thomas Wagner 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.

Is Thomas Wagner affiliated with any hospitals?

According to CMS data, Thomas Wagner is affiliated with Froedtert South Inc..

When was this NPI record last updated?

The NPPES record for Thomas Wagner was last updated on November 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.