DEBORAH BANAZAK WAGENAAR (D.O.) – Geriatric Psychiatry Physician, NPI 1255315628
Geriatric Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,216 PSYCHIATRY in MI
Provider Addresses for DEBORAH BANAZAK WAGENAAR (D.O.)
965 FEE RD ROOM A239
MICHIGAN STATE UNIVERSITY DEPARTMENT OF PSYCHIATRY
EAST LANSING, MI 488242893
Phone: (517) 353-3070
Fax: (517) 432-3603
Type: Mailing
909 FEE RD ROOM B119
MICHIGAN STATE UNIVERSITY DEPARTMENT OF PSYCHIATRY
EAST LANSING, MI 488243603
Phone: (517) 353-3070
Fax: (517) 432-3603
Type: Location
804 SERVICE RD STE A109B
EAST LANSING, MI 488247015
Phone: (517) 353-3070
Fax: (517) 884-1817
Type: Mailing
909 WILSON RD RM B119
EAST LANSING, MI 488246410
Phone: (517) 353-3070
Fax: (517) 884-1817
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2009-03-09
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 |
|---|---|---|---|---|
| I20090309000333 | I | Psychiatry | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48824)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | MI | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 82 | 37 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Osteopathic Manipulative Medicine | MI | |
| Osteopathic Manipulative Medicine | MI | |
| Family Practice | MI | |
| Osteopathic Manipulative Medicine | MI | |
| - | MI | |
| Physical Medicine And Rehabilitation, Osteopathic Manipulative Medicine | MI | |
| Osteopathic Manipulative Medicine | MI | |
| - | MI | |
| Internal Medicine | MI | |
| P S Y C H I A T R Y | MI |
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.