BRADFORD S. WAGNER (MD) – Sports Medicine (Family Medicine) Physician, NPI 1083848030
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
886 FAMILY PRACTICE in ME
Provider Addresses for BRADFORD S. WAGNER (MD)
50 FODEN RD STE 3
SOUTH PORTLAND, ME 041061718
Phone: (207) 874-1489
Fax: (207) 523-8590
Type: Location
100 GANNETT DR STE C
SOUTH PORTLAND, ME 041065900
Phone: (207) 347-2947
Fax: (207) 874-2317
Type: Mailing
100, Gannett Drive, South Portland, Cumberland County, Maine, 04106, United States
SUITE C
SOUTH PORTLAND, ME 041065900
Phone: (207) 828-0361
Fax: (207) 874-1483
Type: Mailing
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: 2013-09-13
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 |
|---|---|---|---|---|
| I20130913000640 | I | Family Practice | ME | 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 |
|---|---|---|---|---|
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 85 | 50 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 71 | 49 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 62 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 47 | 40 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 44 | 44 | $0 |
Insurance plans in this area (ZIP 04106)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | ME | 20610 | Aspiration and/or injection of large joint or joint capsule | 41 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ME | |
| P S Y C H I A T R Y | ME | |
| Physical Therapist In Private Practice | ME | |
| Family Practice | ME | |
| Nurse Practitioner | ME | |
| Family Practice | ME | |
| - | ME | |
| - | ME | |
| Internal Medicine | ME | |
| Internal Medicine | ME |
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