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: November 01, 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
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

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Justin Wagner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pediatric Surgery
200 UCLA MEDICAL PLZ STE 265
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 7 clinicians in this Medicare group
Public Health, State or Local
2509 PICO BLVD
Santa Monica, CA 90405
  • Reassigned Medicare billing, California enrollment
  • 1,939 clinicians in this Medicare group

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

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.

Which organizations bill Medicare for Justin Wagner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Wagner reassigns Medicare benefits to 2 organizations: The Regents Of The University Of California (Los Angeles, CA) and County Of Los Angeles (Santa Monica, CA). Each 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 Justin Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 7 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.