KATHRYN R WAGNER (MD) – Diagnostic Radiology Physician, NPI 1043508617
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,897 DIAGNOSTIC RADIOLOGY in MA
Provider Addresses for KATHRYN R WAGNER (MD)
11995 SINGLETREE LN
STE 500
EDEN PRAIRIE, MN 553445347
Phone: (952) 595-1301
Fax: (612) 294-4903
Type: Mailing
10 BELVIDERE AVE
WORCESTER, MA 01605
Phone: (952) 595-1100
Fax: (612) 294-4903
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $120.
Total Amount is formed as General ($120) + Research ($0) + Ownership ($0) = $120.
Last reported payment date: 2024-08-01 • Largest payer in this snapshot: Nexxt Spine LLC ($120).
Total Amount
$120
General + Research + Ownership
Payments
1
Total payment records
General Amount
$120
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nexxt Spine LLC | $120 |
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: 2019-05-03
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 |
|---|---|---|---|---|
| I20190503000998 | I | Diagnostic Radiology | CT | 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 |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 7,650 | 71 | $0 |
| A9585 | Injection, gadobutrol, 0.1 ml | 1,890 | 24 | $0 |
| 71045 | X-ray of chest, 1 view | 261 | 220 | $0 |
| 77063 | Screening 3d breast mammography | 214 | 214 | $0 |
| 77067 | Screening mammography | 214 | 214 | $0 |
Insurance plans in this area (ZIP 55344)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | MA | 74177 | CT scan of abdomen and pelvis with contrast | 22 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CT | |
| Diagnostic Radiology | RI | |
| Pulmonary Disease, Critical Care (Intensivists) | CT | |
| Interventional Radiology, Diagnostic Radiology | CT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CT | |
| Diagnostic Radiology | MA | |
| - | CT | |
| Diagnostic Radiology | MA | |
| Diagnostic Radiology | CT | |
| - | CT |
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