MR. RICHARD D JR. WAGNER (PT CSCS VCS) – Physical Therapist, NPI 1225103476
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,000 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WI
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Provider Addresses for MR. RICHARD D JR. WAGNER (PT CSCS VCS)
Cheyenne Court, Grafton, Ozaukee County, Wisconsin, 53024, United States
GRAFTON, WI 530240368
Phone: (262) 375-1075
Fax: (262) 375-4975
Type: Location
1710, Malibu Drive, Town of Cedarburg, Ozaukee County, Wisconsin, 53012, United States
CEDARBURG, WI 530129713
Phone: (262) 618-4787
Fax: (262) 375-4975
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.
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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: 2004-01-19
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20040119000454 | I | Physical Therapist In Private Practice | WI | 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 |
|---|---|---|---|---|
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 289 | 21 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 262 | 21 | $0 |
| 97530 | Therapy procedure using functional activities | 217 | 20 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 97 | 16 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 53024)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | WI | 97001 | Physical therapy evaluation | 20 | 20 |
Group practice members
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| Physical Therapist In Private Practice | WI | |
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| Physical Therapist In Private Practice | WI | |
| Physical Therapist In Private Practice | WI | |
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