RICHARD W WAGONER (M.D.) – Internal Medicine Physician, NPI 1861458952
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,824 INTERNAL MEDICINE in IL
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Provider Addresses for RICHARD W WAGONER (M.D.)
Mason District Hospital, 615, North Promenade Street, Havana, Mason County, Illinois, 62644, United States
P O BOX 530
HAVANA, IL 626441015
Phone: (309) 543-6600
Fax: (309) 543-2089
Mailing address matches the actual address.
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.
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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: 2010-05-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100507000571 | I | Internal Medicine | IL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 45380 | Biopsy of large bowel using a flexible endoscope | 24 | 24 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 20 | 13 | $0 |
Insurance plans in this area (ZIP 62644)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL | |
| Emergency Medicine | IL | |
| - | IL | |
| Internal Medicine, Emergency Medicine | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | TN | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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