EMILY KATE WAGNER (MD) – Family Medicine Physician, NPI 1255070553

EMILY KATE WAGNER (MD) is a healthcare provider. based in Waco, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. V6422 (TX). The NPI Number for EMILY KATE WAGNER (MD) is 1255070553

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
EMILY KATE WAGNER (MD)
NPI
1255070553
Phone
(254) 313-4765
Address
1600 Providence Dr
Enumeration Date
3 June 2022
Last Update Date
22 September 2025

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
25472932812131
Graduation Year
2022 (4 years ago)
PAC ID
9537670252
Group Practice PAC ID
9032103700
Professional Enrollment ID
I20250618002144
Address ID
TX766422128GR701XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for EMILY KATE WAGNER (MD)

  • 1600 Providence Dr

    Waco, TX 767072261

    Phone: (254) 313-4765

    Type: Location

  • 1600 PROVIDENCE DR

    WACO, TX 767072261

    Phone: (254) 313-4765

    Type: Mailing

  • 801 MCCLINTIC DR

    GROESBECK, TX 766422130

    Phone: (254) 729-3411

    Fax: (254) 729-3258

    Type: Mailing

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: 2025-06-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250618002144IFamily PracticeTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 76707)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032103700View full group profile

Reviews

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Frequently asked questions

What federal number belongs to EMILY KATE WAGNER (MD)?
The federal identifier for EMILY KATE WAGNER (MD) is NPI 1255070553.
Is EMILY KATE WAGNER (MD) active in the national directory?
EMILY KATE WAGNER (MD)'s public NPI profile is in an active state.
What kind of provider is EMILY KATE WAGNER (MD)?
The page reflects Family Medicine Physician for EMILY KATE WAGNER (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for EMILY KATE WAGNER (MD)?
The page summarizes Waco, Texas for EMILY KATE WAGNER (MD); expand the address list for detail.
Is EMILY KATE WAGNER (MD) a real provider?
This page reflects official NPPES data for NPI 1255070553. Always confirm identity and privileges with the practice and licensing boards.

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