DR. DEANNA MARIE WAGNER (M.D.) – Dermatology Physician, NPI 1104141654
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DERMATOLOGY in MI
Provider Addresses for DR. DEANNA MARIE WAGNER (M.D.)
43900, Garfield Road, Clinton Township, Macomb County, Michigan, 48038, United States
STE 100
CLINTON TWP, MI 480381137
Phone: (586) 286-0112
Fax: (586) 286-1241
Type: Mailing
200 HEALTH PARK DR
OWOSSO, MI 488671291
Phone: (989) 723-6666
Type: Mailing
28333, Harper Avenue, Saint Clair Shores, Macomb County, Michigan, 48081, United States
SAINT CLAIR SHORES, MI 48081
Phone: (586) 776-9770
Fax: (586) 776-9772
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 115 Open Payments records for all available years, with a total value of $2,099.
Total Amount is formed as General ($2,099) + Research ($0) + Ownership ($0) = $2,099.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Janssen Biotech, Inc. ($444).
Total Amount
$2,099
General + Research + Ownership
Payments
115
Total payment records
General Amount
$2,099
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2014-05-07
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 |
|---|---|---|---|---|
| I20140507001474 | I | Dermatology | MI | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 807 | 140 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 215 | 171 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 190 | 151 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 164 | 164 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 74 | 66 | $0 |
Insurance plans in this area (ZIP 48038)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MI | 17003 | Destruction of 2-14 skin growths | 147 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| A N E S T H E S I O L O G Y | IL | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| Physician Assistant | MI |
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