1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Surgery
  6. NPI Profile

JUSTIN PHILIP WAGNER M.D.
NPI 1871818484
Surgery - Pediatric Surgery in Los Angeles, CA

Active since April 07, 2010PECOS Enrolled
200 UCLA MEDICAL PLZ # 265, LOS ANGELES, CA 90095(310) 206-2429 Get Directions Write a Review

NPPES record last updated: November 5, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 5, 2019, Jul 2, 2019 (2 updates tracked since 2019).

About Justin Philip Wagner M.d. NPPES

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

JUSTIN PHILIP WAGNER M.D. (NPI 1871818484) is an individual pediatric surgery provider in Los Angeles, California, licensed in California (A117746) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS and maintains a secondary practice location in Santa Clarita.

NPPES Registry Identity

NPI1871818484
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameJUSTIN PHILIP WAGNERCredential: M.D.
Location Address200 UCLA MEDICAL PLZ # 265Los Angeles, CA 90095-8344
Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631
Phone(310) 206-2429
Sole ProprietorNo
Enumeration DateApril 7, 2010
Last NPPES UpdateNovember 5, 20192 updates tracked since enumeration
✔ NPI 1871818484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in CA · A117746
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedSurgeryTaxonomy 208600000X · License A117746 (CA)
200 UCLA MEDICAL PLZ # 265, Los Angeles, CA 90095
Open in Google Maps ↗

Secondary Practice Location 1

Location 127235 Tourney Rd Ste 2500Santa Clarita, CA 91355-5908 · Phone (310) 206-2429 · Fax (310) 206-1120

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Philip Wagner M.d. 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.

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 Justin Wagner's NPI number?

The NPI number for Justin Wagner is 1871818484. It was assigned to this individual provider in the NPPES registry on April 7, 2010.

Where is Justin Wagner located?

Justin Wagner practices at 200 Ucla Medical Plz # 265, Los Angeles, CA 90095. The listed phone number is (310) 206-2429.

What is Justin Wagner's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Justin Wagner enrolled in Medicare?

Yes. Justin Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Wagner was last updated on November 5, 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.