KRYSTN RAE WAGNER (MD) – Infectious Disease Physician, NPI 1669455127
Infectious Disease Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210513001004 | I | Internal Medicine | GA | TBD |
| I20240109003747 | I | Infectious Disease | TN | TBD |
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.
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
- 1
- 2
- 3
- 4
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | TN | |
| Pediatric Medicine | TN | |
| - | TN | |
| - | TN | |
| Diagnostic Radiology, Interventional Pain Management | TN | |
| Certified Registered Nurse Anesthetist (Crna) | TN | |
| N E U R O L O G Y | TN | |
| - | TN | |
| Physician Assistant | TN | |
| Internal Medicine | TN |
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