KRYSTN RAE WAGNER (MD) – Infectious Disease Physician, NPI 1669455127

KRYSTN RAE WAGNER (MD) is a healthcare provider. based in New haven, Connecticut. specializing in INFECTIOUS DISEASE, INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 040631 (CT). The NPI Number for KRYSTN RAE WAGNER (MD) is 1669455127

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
KRYSTN RAE WAGNER (MD)
NPI
1669455127
Phone
(203) 777-7411
Address
374 GRAND AVE
Enumeration Date
29 November 2005
Last Update Date
26 October 2023

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6153223000
Graduation Year
1996 (30 years ago)
PAC ID
0840260527
Group Practice PAC ID
5092023416
Professional Enrollment ID
I20240109003747
Address ID
TN372325100NA1301XSXXX400

Contacts

Secure Messaging
kwagner774401@direct.vumc.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience92
Completeness85
Years active:20State licenses:3Other namesUpdated within 12 months

218 INFECTIOUS DISEASE in CT

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Provider Addresses for KRYSTN RAE WAGNER (MD)

  • Fair Haven Health Clinic, 374, Grand Avenue, Mill River, Barnesville, New Haven, New Haven County, Connecticut, 06513, United States

    NEW HAVEN, CT 065133733

    Phone: (203) 777-7411

    Fax: (203) 777-8506

    Type: Location

  • 3841 GREEN HILLS VILLAGE DR

    NASHVILLE, TN 372152691

    Phone:

    Type: Mailing

  • 3601 THE VANDERBILT CLINIC

    NASHVILLE, TN 372323733

    Phone: (615) 322-3000

    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: 2024-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20210513001004IInternal MedicineGATBD
I20240109003747IInfectious DiseaseTNTBD

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 06513)

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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: 5092023416View full group profile
NameSpecialtyState
Diagnostic RadiologyTN
Pediatric MedicineTN
-TN
-TN
Diagnostic Radiology, Interventional Pain ManagementTN
Certified Registered Nurse Anesthetist (Crna)TN
N E U R O L O G YTN
-TN
Physician AssistantTN
Internal MedicineTN

Reviews

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Frequently asked questions

What unique ID ties claims to KRYSTN RAE WAGNER (MD)?
NPI 1669455127 is assigned to KRYSTN RAE WAGNER (MD) under the national enumeration system.
Is KRYSTN RAE WAGNER (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does KRYSTN RAE WAGNER (MD) work in?
You can think of KRYSTN RAE WAGNER (MD) as practicing within Infectious Disease Physician. Clinical services aligned with this taxonomy classification.
Where does public data place KRYSTN RAE WAGNER (MD)?
The snapshot lists New Haven, Connecticut for KRYSTN RAE WAGNER (MD); download NPPES for the complete set.
What if New Haven, Connecticut seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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