MR. MICHAEL T WAGNON (PT) – Physical Therapist, NPI 1366491755

MR. MICHAEL T WAGNON (PT) is a healthcare provider. based in Denver, Colorado. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 3047 (NM). The NPI Number for MR. MICHAEL T WAGNON (PT) is 1366491755

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
MR. MICHAEL T WAGNON (PT)
NPI
1366491755
Phone
Not provided
Address
10350 E DAKOTA AVE
Enumeration Date
10 May 2006
Last Update Date
20 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3033384545
Graduation Year
2003 (23 years ago)
PAC ID
1759481815
Group Practice PAC ID
1254238454
Professional Enrollment ID
I20070703000353
Address ID
CO800263370LA280XXCIRC301

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness85
Years active:20State licenses:2Other namesUpdated within 12 months

2,988 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CO

Provider Addresses for MR. MICHAEL T WAGNON (PT)

  • 10350 E DAKOTA AVE

    DENVER, CO 802471314

    Phone:

    Type: Mailing

  • 280 EXEMPLA CIR

    LAFAYETTE, CO 800263370

    Phone: (303) 338-4545

    Type: Location

  • Kaiser Permanente, 2500, South Havana Street, Aurora, Arapahoe County, Colorado, 80014, United States

    AURORA, CO 800141618

    Phone: (303) 338-4545

    Type: Mailing

  • 8383, West Alameda Avenue, Lakewood, Jefferson County, Colorado, 80226, United States

    LAKEWOOD, CO 802263007

    Phone: (303) 338-4545

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-07-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070703000353IPhysical Therapist In Private PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 80247)

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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: 1254238454View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Physical Therapist In Private PracticeCO
-CO
-CO
-CO
Cardiovascular Disease (Cardiology)CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Family PracticeCO

Reviews

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Frequently asked questions

What is the registry number for MR. MICHAEL T WAGNON (PT)?
The registry entry for MR. MICHAEL T WAGNON (PT) shows NPI 1366491755.
Should I treat MR. MICHAEL T WAGNON (PT) as an active provider?
Patients and plans typically see MR. MICHAEL T WAGNON (PT) as active in the national extract.
What does the directory say MR. MICHAEL T WAGNON (PT) does?
Insurance directories may phrase it differently, but here MR. MICHAEL T WAGNON (PT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to MR. MICHAEL T WAGNON (PT)?
The directory associates MR. MICHAEL T WAGNON (PT) with Denver, Colorado. Check all listed addresses for suites or satellite offices.
Can I export MR. MICHAEL T WAGNON (PT)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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