JASON FREDRICK WAGNER (APRN, LMHC, MCAP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1720536691

JASON FREDRICK WAGNER (APRN, LMHC, MCAP) is a healthcare provider. based in Davie, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, LMHC, MCAP. They hold a License No. MH8961 (FL). The NPI Number for JASON FREDRICK WAGNER (APRN, LMHC, MCAP) is 1720536691

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JASON FREDRICK WAGNER (APRN, LMHC, MCAP)
NPI
1720536691
Phone
(954) 483-5455
Address
12521 SW 11TH CT
Enumeration Date
20 September 2016
Last Update Date
1 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9549622009
Graduation Year
2019 (7 years ago)
PAC ID
2668806159
Group Practice PAC ID
4082710835
Professional Enrollment ID
I20250421002841
Address ID
FL330213860HO111XXWAYX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for JASON FREDRICK WAGNER (APRN, LMHC, MCAP)

  • 12521 SW 11TH CT

    DAVIE, FL 333255585

    Phone: (954) 483-5455

    Type: Mailing

  • 6075 BATHEY LN

    NAPLES, FL 341167536

    Phone: (239) 455-8500

    Type: Location

  • 135 WESTON RD # 236

    WESTON, FL 333261111

    Phone: (954) 483-5455

    Type: Mailing

  • 111 W CORAL WAY

    HOLLYWOOD, FL 330213860

    Phone: (954) 964-6338

    Fax: (954) 965-1327

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $753.

Total Amount is formed as General ($753) + Research ($0) + Ownership ($0) = $753.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($286).

Total Amount

$753

General + Research + Ownership

Payments

6

Total payment records

General Amount

$753

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2025-04-21

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
I20191216001077INurse PractitionerFLTBD
I20250421002841INurse PractitionerTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 33325)

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: 4082710835View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerMO
Family Practice, Osteopathic Manipulative MedicineFL
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantWV

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Where can patients find JASON FREDRICK WAGNER (APRN, LMHC, MCAP)'s NPI?
You can confirm JASON FREDRICK WAGNER (APRN, LMHC, MCAP) with NPI 1720536691; it appears in the national provider directory.
Is JASON FREDRICK WAGNER (APRN, LMHC, MCAP) active in the national directory?
JASON FREDRICK WAGNER (APRN, LMHC, MCAP)'s public NPI profile is in an active state.
Does JASON FREDRICK WAGNER (APRN, LMHC, MCAP) list a primary specialty?
If you are matching referrals, note Psychiatric/Mental Health Nurse Practitioner for JASON FREDRICK WAGNER (APRN, LMHC, MCAP). Clinical services aligned with this taxonomy classification.
What location shows for JASON FREDRICK WAGNER (APRN, LMHC, MCAP)?
We surface Davie, Florida for JASON FREDRICK WAGNER (APRN, LMHC, MCAP) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

Similar Providers

MENTAL HEALTH MATTER

Psychiatric/Mental Health Nurse Practitioner
14201 W SUNRISE BLVD STE 104
NPI: 1346563079
16 FREDERICKSBURG DR
NPI: 1457664104

MS. BARBARA JOAN CONNOLD (ARNP)

Psychiatric/Mental Health Nurse Practitioner
665 NE 88TH ST
NPI: 1992072698

MONICA SCACCIANOCE (APRN, DNP)

Psychiatric/Mental Health Nurse Practitioner
4740 N STATE ROAD 7
NPI: 1831437755

YOLANDA CARDONA (ARNP FNP-BC)

Psychiatric/Mental Health Nurse Practitioner
5400 S UNIVERSITY DR STE 407A
NPI: 1821425547
8958 W STATE ROAD 84 STE 342
NPI: 1891110342

J & G MEDICAL ASSOCIATES PA

Psychiatric/Mental Health Nurse Practitioner
4100 S HOSPITAL DR STE 102
NPI: 1184042079

MRS. MICHELLE LEE BLAIR (ARNP)

Psychiatric/Mental Health Nurse Practitioner
3114 PEACHTREE CIR
NPI: 1376927129

TRACIAN PATRICE KELLY (ARNP)

Psychiatric/Mental Health Nurse Practitioner
1650 OSCEOLA DR
NPI: 1467824904