MICHAEL SCOTT WAGNER (OD) – Optometrist, NPI 1215676572

MICHAEL SCOTT WAGNER (OD) is a healthcare provider. based in Mill creek, Washington. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OD61308446 (WA). The NPI Number for MICHAEL SCOTT WAGNER (OD) is 1215676572

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL SCOTT WAGNER (OD)
NPI
1215676572
Phone
(425) 481-4440
Address
16708 BOTHELL EVERETT HWY STE 103
Enumeration Date
3 June 2022
Last Update Date
3 June 2022

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
3603576683
Graduation Year
2022 (4 years ago)
PAC ID
5890168488
Group Practice PAC ID
8820080237
Professional Enrollment ID
I20230301002285
Address ID
WA985025735OL1625XSWXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for MICHAEL SCOTT WAGNER (OD)

  • 16708 BOTHELL EVERETT HWY STE 103

    MILL CREEK, WA 980126345

    Phone: (425) 481-4440

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $542.

Total Amount is formed as General ($542) + Research ($0) + Ownership ($0) = $542.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Alcon Vision LLC ($205).

Total Amount

$542

General + Research + Ownership

Payments

16

Total payment records

General Amount

$542

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-03-01

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
I20230301002285IOptometryWATBD

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 98012)

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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: 8820080237View full group profile
NameSpecialtyState
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YOR
O P T O M E T R YIL
-WA
O P T O M E T R YMA
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA

Reviews

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Frequently asked questions

What NPI should I save for MICHAEL SCOTT WAGNER (OD)?
Save NPI 1215676572 if you need a stable reference for MICHAEL SCOTT WAGNER (OD).
Is MICHAEL SCOTT WAGNER (OD)'s NPI currently valid?
The extract we use shows MICHAEL SCOTT WAGNER (OD) as active.
Can you summarize MICHAEL SCOTT WAGNER (OD)'s specialty in plain language?
Clinically, the directory lists MICHAEL SCOTT WAGNER (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHAEL SCOTT WAGNER (OD)?
The page summarizes Mill Creek, Washington for MICHAEL SCOTT WAGNER (OD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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