ROBERT ALLAN WAGENECK (DO) – Family Medicine Physician, NPI 1861450314

ROBERT ALLAN WAGENECK (DO) is a healthcare provider. based in Clifton, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. N2875 (TX). The NPI Number for ROBERT ALLAN WAGENECK (DO) is 1861450314

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT ALLAN WAGENECK (DO)
NPI
1861450314
Phone
(254) 675-8621
Address
201 POSEY AVE
Enumeration Date
3 May 2006
Last Update Date
19 January 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
5099338777
Graduation Year
1994 (32 years ago)
PAC ID
1153365358
Group Practice PAC ID
0547179608
Professional Enrollment ID
I20191223000217
Address ID
WA989263692EL100XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for ROBERT ALLAN WAGENECK (DO)

  • 201 POSEY AVE

    CLIFTON, TX 766341200

    Phone: (254) 675-8621

    Fax: (254) 675-2254

    Type: Location

  • 501, South 5th Avenue, Yakima, Yakima County, Washington, 98902, United States

    YAKIMA, WA 989023550

    Phone: (509) 853-1082

    Fax: (509) 573-6275

    Type: Mailing

  • 521 E MOUNTAIN VIEW AVE

    ELLENSBURG, WA 989263865

    Phone: (509) 962-1414

    Fax: (509) 962-1408

    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: 2019-12-23

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
I20191223000217IFamily PracticeWATBD

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 76634)

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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: 0547179608View full group profile
NameSpecialtyState
Nurse PractitionerWA
Emergency MedicineWA
General SurgeryWA
Cardiac Electrophysiology, Internal MedicineMN
O T O L A R Y N G O L O G YWA
Family PracticeWA
Physician AssistantWA
Physician AssistantID
-WA
O B S T E T R I C S/ G Y N E C O L O G YWA

Reviews

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Frequently asked questions

What number should I use to identify ROBERT ALLAN WAGENECK (DO) for billing?
Administrative and clinical systems typically use NPI 1861450314 for ROBERT ALLAN WAGENECK (DO).
Does the public listing show ROBERT ALLAN WAGENECK (DO) as active?
ROBERT ALLAN WAGENECK (DO)'s NPI record reflects an active status in NPPES.
What type of care does ROBERT ALLAN WAGENECK (DO) provide?
ROBERT ALLAN WAGENECK (DO)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ROBERT ALLAN WAGENECK (DO)?
ROBERT ALLAN WAGENECK (DO) is associated with Clifton, Texas in the same public data insurers reference.
Why is information missing for ROBERT ALLAN WAGENECK (DO)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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