MR. GARY L. WAGNER (CRNA) – Registered Nurse, NPI 1699842229
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
990 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WA
Provider Addresses for MR. GARY L. WAGNER (CRNA)
PO BOX 35145 #40023
SEATTLE, WA 981245145
Phone: (425) 407-1500
Fax: (425) 407-1112
Type: Mailing
7058 N MADELLAINE DR
COEUR D ALENE, ID 838157108
Phone: (253) 334-3886
Type: Mailing
16010 E INDIANA AVE
SPOKANE VALLEY, WA 992161813
Phone: (509) 928-8040
Type: Location
West Kootenai Health Way, Coeur d'Alene, Kootenai County, Idaho, 83815, United States
COEUR D ALENE, ID 838146051
Phone: (208) 765-8585
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $105.
Total Amount is formed as General ($105) + Research ($0) + Ownership ($0) = $105.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Mallinckrodt Hospital Products Inc. ($45).
Total Amount
$105
General + Research + Ownership
Payments
4
Total payment records
General Amount
$105
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-09-29
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 |
|---|---|---|---|---|
| I20040823000801 | I | Certified Registered Nurse Anesthetist (Crna) | WA | TBD |
| I20200929001105 | I | Certified Registered Nurse Anesthetist (Crna) | ID | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 354 | 208 | $0 |
| 00140 | Anesthesia for other procedure on eye | 29 | 22 | $0 |
Insurance plans in this area (ZIP 98124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| - | WA | |
| - | OR | |
| O P H T H A L M O L O G Y | CA | |
| O P H T H A L M O L O G Y | FL | |
| - | OR | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P H T H A L M O L O G Y | OR |
Reviews
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