DR. STEPHEN R WAGNER – Pain Medicine (Anesthesiology) Physician, NPI 1063524387
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
969 ANESTHESIOLOGY in MN
Provider Addresses for DR. STEPHEN R WAGNER
2104 Northdale Blvd NW Ste 220
Coon Rapids, MN 554333046
Phone: (763) 537-6000
Type: Location
Eagle Point Boulevard, Lake Elmo, Washington County, Minnesota, 55125, United States
LAKE ELMO, MN 550428628
Phone: (651) 251-8021
Fax: (651) 251-8050
Type: Mailing
United Hospital, 333, Smith Avenue North, West Seventh - Fort Road, Saint Paul, Ramsey County, Minnesota, 55102, United States
SAINT PAUL, MN 551022344
Phone: (651) 735-0501
Fax: (651) 735-1870
Type: Location
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: 2007-01-10
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 |
|---|---|---|---|---|
| I20070110000420 | I | Anesthesiology | MN | 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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 93 | 90 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 15 | 15 | $0 |
| 64447 | Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve) | 14 | 14 | $0 |
| 00300 | Anesthesia for other procedure on skin, muscles, or nerves of head, neck, and upper back | 11 | 11 | $0 |
| 00910 | Anesthesia for other procedure on urinary system through urethra | 11 | 11 | $0 |
Insurance plans in this area (ZIP 55433)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| A N E S T H E S I O L O G Y | MN | |
| A N E S T H E S I O L O G Y | MN |
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