AMANDA ELLEN WAGNER (MD) – Obstetrics & Gynecology Physician, NPI 1235457359
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
632 OBSTETRICS/GYNECOLOGY in OR
Provider Addresses for AMANDA ELLEN WAGNER (MD)
PO BOX 577
STAYTON, OR 973830577
Phone: (503) 769-2175
Fax: (503) 769-3472
Type: Mailing
1373 N 10TH AVE
STAYTON, OR 973832037
Phone: (503) 769-9522
Fax: (503) 769-9530
Type: Location
PO BOX 636961
CINCINNATI, OH 452636961
Phone: (513) 981-5130
Fax: (513) 981-5015
Type: Mailing
1532 LONE OAK RD
SUITE 245
PADUCAH, KY 420037913
Phone: (270) 538-5700
Fax: (270) 538-5701
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $332.
Total Amount is formed as General ($332) + Research ($0) + Ownership ($0) = $332.
Last reported payment date: 2024-10-16 • Largest payer in this snapshot: Shield Therapeutics Inc ($60).
Total Amount
$332
General + Research + Ownership
Payments
15
Total payment records
General Amount
$332
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Shield Therapeutics Inc | $60 |
| Daiichi Sankyo Inc. | $53 |
| PFIZER INC. | $50 |
| MAYNE PHARMA COMMERCIAL LLC | $44 |
| Myriad Women's Health, Inc. | $40 |
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: 2023-09-19
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 |
|---|---|---|---|---|
| I20230919001865 | I | Obstetrics/Gynecology | OR | 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 | 13 | 12 | $0 |
Insurance plans in this area (ZIP 97383)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Cardiovascular Disease (Cardiology) | CA | |
| - | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | OR | |
| Family Practice | OR | |
| P O D I A T R Y | OR | |
| General Surgery | OR | |
| Family Practice | OR | |
| Internal Medicine | OR |
Reviews
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