Dr Derrick Durell Wagoner, DO - Medicare Pain Management in Edmond, OK

Dr Derrick Durell Wagoner, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Edmond, Oklahoma. He went to West Virginia School Of Osteopathic Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as Pain Management. He is a member of the group practice Associated Radiologists Of The Finger Lakes, P.c., Gershon Pain Specialists Llc, Associated Radiologists Of The Finger Lakes, P.c. and his current practice location is 1800 Renaissance Blvd Ste 110, Edmond, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (405) 601-2325.

Dr Derrick Durell Wagoner is licensed to practice in Oklahoma (license number 6324) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760829220.

Contact Information

Dr Derrick Durell Wagoner, DO
1800 Renaissance Blvd Ste 110,
Edmond, OK 73013
(405) 601-2325
Not Available



Physician's Profile

Full NameDr Derrick Durell Wagoner
GenderMale
SpecialityPain Management
Experience11 Years
Location1800 Renaissance Blvd Ste 110, Edmond, Oklahoma
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Derrick Durell Wagoner attended and graduated from West Virginia School Of Osteopathic Medicine in 2013
  NPI Data:
  • NPI Number: 1760829220
  • Provider Enumeration Date: 05/23/2013
  • Last Update Date: 08/31/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 8123383205
  • Enrollment ID: I20190815003092

Medical Identifiers

Medical identifiers for Dr Derrick Durell Wagoner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1760829220NPI-NPPES
200769850AMedicaidOK

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 6324 (Oklahoma)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Arnot Ogden Medical CenterElmira, NYHospital
Ira Davenport Memorial HospitalBath, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Associated Radiologists Of The Finger Lakes, P.c.52946239559
Gershon Pain Specialists Llc76180758214
Associated Radiologists Of The Finger Lakes, P.c.52946239559

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Derrick Durell Wagoner allows following entities to bill medicare on his behalf.
Entity NameGershon Pain Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871710798
PECOS PAC ID: 7618075821
Enrollment ID: O20070612000673

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Entity NameAssociated Radiologists Of The Finger Lakes, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063489060
PECOS PAC ID: 5294623955
Enrollment ID: O20210913000024

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Derrick Durell Wagoner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Derrick Durell Wagoner, DO
321 Shappee St,
Horseheads, NY 14845-1918

Ph: () -
Dr Derrick Durell Wagoner, DO
1800 Renaissance Blvd Ste 110,
Edmond, OK 73013

Ph: (405) 601-2325

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Radiology Doctors in Edmond, OK

Laurie J Hast, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1208 Blue Wister Cv, Edmond, OK 73013
Phone: 405-255-4519    
Donald Wayne Nix, M.D.
Radiology
Medicare: Medicare Enrolled
Practice Location: 902 S Bryant Ave, Edmond, OK 73034
Phone: 405-348-1900    Fax: 405-348-0423
James Delbert Crooks, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 902 S Bryant Ave, Edmond, OK 73034
Phone: 405-348-1900    Fax: 405-348-0423
Robin E Acker, MD
Radiology
Medicare: Medicare Enrolled
Practice Location: 1849 Fairmont Ln, Edmond, OK 73013
Phone: 405-659-4120    
Dr. Lori Ann Fredrick, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2601 Kelley Pointe Pkwy, Ste. 101, Edmond, OK 73013
Phone: 405-844-2601    Fax: 405-844-2610
James Keith Cooper, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 3509 French Park Dr, Ste E, Edmond, OK 73034
Phone: 405-285-6901    Fax: 405-285-6902
Rodney Alen Kernes, D.O.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 432 Pacific Crest Trl, Edmond, OK 73003
Phone: 952-595-1100    Fax: 612-294-4903

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