Kyle L Wagamon, MD - Medicare Dermatology in Warren, OH

Kyle L Wagamon, MD is a medicare enrolled "Dermatology - Dermatopathology" physician in Warren, Ohio. He went to Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University and graduated in 2002 and has 22 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Brodell Medical Inc and his current practice location is 2660 E Market St, Warren, Ohio. You can reach out to his office (for appointments etc.) via phone at (330) 393-4000.

Kyle L Wagamon is licensed to practice in Ohio (license number 35083746) 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 1780758003.

Contact Information

Kyle L Wagamon, MD
2660 E Market St,
Warren, OH 44483-6204
(330) 393-4000
(330) 392-5870



Physician's Profile

Full NameKyle L Wagamon
GenderMale
SpecialityDermatology
Experience22 Years
Location2660 E Market St, Warren, Ohio
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:
  • Kyle L Wagamon attended and graduated from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 2002
  NPI Data:
  • NPI Number: 1780758003
  • Provider Enumeration Date: 11/20/2006
  • Last Update Date: 01/17/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 6507968385
  • Enrollment ID: I20070711000043

Medical Identifiers

Medical identifiers for Kyle L Wagamon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780758003NPI-NPPES
7474933OtherOHAETNA
000000217451OtherOHUNISON
P00406585OtherOHRAILROAD MEDICARE
415051OtherOHWELLCARE
000000527821OtherOHANTHEM
2754827MedicaidOH
748956OtherOHBUCKEYE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology 35083746 (Ohio)Secondary
207ND0900XDermatology - Dermatopathology 35083746 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mh St Joseph Warren HospitalWarren, OHHospital
Trumbull Regional Medical CenterWarren, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Brodell Medical Inc66087695267

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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. Kyle L Wagamon allows following entities to bill medicare on his behalf.
Entity NameBrodell Medical Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922129659
PECOS PAC ID: 6608769526
Enrollment ID: O20040205000017

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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. Kyle L Wagamon 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
Kyle L Wagamon, MD
19301 Cyclone Dr,
Cleveland, OH 44135-1731

Ph: (330) 393-4000
Kyle L Wagamon, MD
2660 E Market St,
Warren, OH 44483-6204

Ph: (330) 393-4000

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Dermatology Doctors in Warren, OH

Dr. Indira Krishnarao, M.D.
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 735 Niles Cortland Rd Se, Warren, OH 44484
Phone: 330-856-6365    Fax: 330-609-5088
Dr. Rachel Lynn Delost, DO
Dermatology
Medicare: Medicare Enrolled
Practice Location: 2223 Niles Cortland Rd Se, Warren, OH 44484
Phone: 330-965-8760    Fax: 330-469-9706
Morgan Hott,
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 735 Niles Cortland Rd Se, Warren, OH 44484
Phone: 330-856-6365    Fax: 330-474-3981

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