DR. JACKSON WAGONER (MD) – Pain Medicine (Anesthesiology) Physician, NPI 1689137408
Pain Medicine (Anesthesiology) Physician
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Profile Insights
NPPES metrics only — not quality of care.
3,340 ANESTHESIOLOGY in FL
Provider Addresses for DR. JACKSON WAGONER (MD)
1600 SW Archer Rd
Gainesville, FL 326101702
Phone: (352) 273-8610
Fax: (352) 273-8612
Type: Location
300 PASTEUR DR RM H3680
STANFORD, CA 943052200
Phone: (650) 725-2181
Type: Mailing
PO BOX 100254
GAINESVILLE, FL 326100254
Phone: (352) 273-8610
Fax: (352) 273-8612
Type: Mailing
1600 SW ARCHER RD
GAINESVILLE, FL 326101702
Phone: (352) 273-8610
Fax: (352) 273-8612
Type: Location
1501 N Campbell Ave Rm 4401
Tucson, AZ 857240001
Phone: (520) 626-7721
Type: Location
2600 Sixth St SW
Canton, OH 447101702
Phone: (330) 452-9911
Type: Location
1541 DIAMOND DR
CASPER, WY 826016247
Phone: (307) 439-1097
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $67,889.
Total Amount is formed as General ($67,889) + Research ($0) + Ownership ($0) = $67,889.
Last reported payment date: 2024-08-29 • Largest payer in this snapshot: Boston Scientific Corporation ($34,619).
Total Amount
$67,889
General + Research + Ownership
Payments
59
Total payment records
General Amount
$67,889
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $34,619 |
| Medtronic, Inc. | $21,483 |
| Abbott Laboratories | $9,259 |
| Nevro Corp. | $1,757 |
| Saluda Medical Americas, Inc. | $261 |
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: 2026-02-19
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 |
|---|---|---|---|---|
| I20240709004906 | I | Anesthesiology | FL | TBD |
| I20260219002020 | I | Anesthesiology | WY | 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 32610)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | FL | |
| Nurse Practitioner | FL | |
| G A S T R O E N T E R O L O G Y | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL |
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