MARK T. WAGNER (DO) – Family Medicine Physician, NPI 1346373446
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARK T. WAGNER (DO)
450 SHUPE AVE
AMHERST, OH 440012349
Phone: (419) 294-4991
Fax: (419) 294-2233
Type: Mailing
885 N SANDUSKY AVE
UPPER SANDUSKY, OH 433511031
Phone: (419) 294-4991
Fax: (419) 294-2233
Type: Location
1735 27TH ST STE B06
PORTSMOUTH, OH 456622681
Phone: (740) 356-8681
Fax: (740) 353-7900
Type: Mailing
1248 KINNEYS LN
PORTSMOUTH, OH 456622994
Phone: (740) 356-7290
Fax: (740) 356-7938
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: 2008-02-21
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 |
|---|---|---|---|---|
| I20080221000036 | I | Emergency Medicine | OH | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 277 | 245 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 45 | 41 | $0 |
Insurance plans in this area (ZIP 44001)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| - | OH | |
| - | OH | |
| - | OH |
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.