DR. JERE L WAGNER (MD) – Family Medicine Physician, NPI 1730151358
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JERE L WAGNER (MD)
460 River Ave
Williamsport, PA 177013723
Phone: (570) 213-5221
Fax: (570) 227-3316
Type: Location
3832 Yalick Plaza Route 415
Unit 7
Dallas, PA 186127753
Phone: (570) 213-5221
Fax: (570) 227-3316
Type: Location
2 N 8TH ST
SHAMOKIN, PA 178725607
Phone: (570) 644-1780
Type: Location
100, Shenango Avenue, Sharon, Mercer County, Pennsylvania, 16146, United States
SHARON, PA 161461503
Phone: (570) 671-0300
Fax: (570) 671-0305
Type: Mailing
624, West Centre Street, Shenandoah, Schuylkill County, Pennsylvania, 17976, United States
SHENANDOAH, PA 179761403
Phone: (570) 671-0300
Fax: (570) 671-0305
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: 2007-09-10
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 |
|---|---|---|---|---|
| I20070910000446 | I | Family Practice | PA | 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 17701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | PA | |
| C H I R O P R A C T I C | PA | |
| Mental Health Counselor | PA | |
| Family Practice | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA | |
| Clinical Social Worker | PA | |
| Mental Health Counselor | PA | |
| Nurse Practitioner | PA |
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