GARY WAGNER (M.D.) – Dermatology Physician, NPI 1235160102

Dermatology Physician

GARY WAGNER (M.D.) is a healthcare provider. based in Modesto, California. specializing in Dermatology Physician. They hold the professional credentials M.D.. They hold a License No. A24987 (CA). The NPI Number for GARY WAGNER (M.D.) is 1235160102

Main info

Male

55 Years Of Experience

Accepts Medicare Assignment

Name

GARY WAGNER (M.D.)

NPI

1235160102

Phone

(209) 524-1211

Address

600 COFFEE RD

Enumeration Date

6 July 2006

Last Update Date

1 April 2016

Doctor Profile

Medical School Name

UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE

Secondary Phone

2095504780

Graduation Year

1971 (55 years ago)

PAC ID

1456477413

Group Practice PAC ID

9830094515

Professional Enrollment ID

I20100927001350

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience52

Completeness75

Years active:19State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for GARY WAGNER (M.D.)

600, Coffee Road, Modesto, Stanislaus County, California, 95355, United States
MODESTO, CA 953554201
Phone: (209) 524-1211
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95355)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9830094515View full group profile

Name	Specialty	State
DR. AMIN MATIN (M.D., M.P.H.)	Diagnostic Radiology	CA
JAMES J STEIDLER (MD)	Diagnostic Radiology	CA
DR. ANNE AN-RU CHEN (M.D.)	Internal Medicine	CA
RONALD D. JENSEN (DPM)	-	CA
PALLAVI SHARMA (MD)	Family Practice	CA
GARRETT P RYLE (MD)	-	CA
KENNETH IMANAKA (MD)	-	CA
JUN LU (M.D.)	Allergy/Immunology, Rheumatology	CA
MARY ANN MARKIEWITZ (PA-C)	Physician Assistant	CA
MARIAH DAWN HUGHES (PA-C)	Physician Assistant	CA