DR. MATTHEW DALE WAGNER (M.D.) – Urology Physician, NPI 1487869996
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
173 UROLOGY in OR
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Provider Addresses for DR. MATTHEW DALE WAGNER (M.D.)
OHSU Center For Health And Healing, 3303, Southwest Bond Avenue, South Portland, Portland, Metro, Multnomah County, Oregon, 97239, United States
CH10U
PORTLAND, OR 972394501
Phone: (503) 494-8311
Fax: (503) 494-8671
Type: Location
1836, Southeast 36th Avenue, Richmond, Portland, Multnomah County, Oregon, 97214, United States
PORTLAND, OR 972145128
Phone: (503) 525-5833
Type: Mailing
1230 7th Ave
Longview, WA 986323166
Phone: (800) 813-2000
Fax: (855) 524-5255
Type: Location
3303 SW Bond Ave
CH10U
Portland, OR 972394501
Phone: (503) 494-8311
Fax: (503) 494-8671
Type: Location
12607 SE Mill Plain Blvd
Vancouver, WA 986846055
Phone: (800) 813-2000
Fax: (855) 524-5255
Type: Location
500 NE MULTNOMAH ST STE 100
PORTLAND, OR 972322031
Phone: (800) 813-2000
Fax: (855) 524-5255
Type: Mailing
9900 SE SUNNYSIDE RD
CLACKAMAS, OR 970159777
Phone: (800) 813-2000
Fax: (855) 524-5255
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.
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: 2009-10-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20080730000422 | I | Urology | OR | TBD |
| I20091006000727 | I | Urology | WA | 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 97239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | TX | |
| Emergency Medicine | OR | |
| D E R M A T O L O G Y | AZ | |
| Nurse Practitioner | OR | |
| Diagnostic Radiology | OR | |
| D E R M A T O L O G Y | WA | |
| - | OR | |
| - | CA | |
| General Surgery | CA | |
| - | OR |
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