Ryan J Wagner, - Medicare Sports Medicine in Appleton, WI

Ryan J Wagner, is a medicare enrolled "Emergency Medicine - Sports Medicine" physician in Appleton, Wisconsin. He went to Midwestern University, Chicago College Of Osteopathic Med and graduated in 2014 and has 10 years of diverse experience with area of expertise as Sports Medicine. He is a member of the group practice Thedacare Incorporated and his current practice location is 2400 E Capitol Dr, Appleton, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 454-3300.

Ryan J Wagner is licensed to practice in Wisconsin (license number 68001) 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 1275087207.

Contact Information

Ryan J Wagner,
2400 E Capitol Dr,
Appleton, WI 54911-8728
(920) 454-3300
(920) 531-2098



Physician's Profile

Full NameRyan J Wagner
GenderMale
SpecialitySports Medicine
Experience10 Years
Location2400 E Capitol Dr, Appleton, Wisconsin
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:
  • Ryan J Wagner attended and graduated from Midwestern University, Chicago College Of Osteopathic Med in 2014
  NPI Data:
  • NPI Number: 1275087207
  • Provider Enumeration Date: 08/08/2016
  • Last Update Date: 02/29/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0547558041
  • Enrollment ID: I20180206002309

Medical Identifiers

Medical identifiers for Ryan J Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275087207NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PS0010XEmergency Medicine - Sports Medicine 68001 (Wisconsin)Primary
207X00000XOrthopaedic Surgery 68001 (Wisconsin)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Thedacare Regional Medical Center - Appleton IncAppleton, WIHospital
Thedacare Medical Center-waupacaWaupaca, WIHospital
Thedacare Regional Med Ctr - NeenahNeenah, WIHospital
Thedacare Medical Center - Wild RoseWild rose, WIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Thedacare Incorporated1759294887493

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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. Ryan J Wagner allows following entities to bill medicare on his behalf.
Entity NameThedacare Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376656959
PECOS PAC ID: 1759294887
Enrollment ID: O20031106000088

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Entity NameMercy Health System Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031113000164

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Entity NameIhc-st Nicholas Emergency Physicians, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245288836
PECOS PAC ID: 2264403021
Enrollment ID: O20040804001040

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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. Ryan J Wagner 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
Ryan J Wagner,
2400 E Capitol Dr,
Appleton, WI 54911-8728

Ph: (920) 831-5050
Ryan J Wagner,
2400 E Capitol Dr,
Appleton, WI 54911-8728

Ph: (920) 454-3300

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Emergency Medicine Doctors in Appleton, WI

Kirsten W Larson, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 3329 N Richmond Street, Appleton, WI 54911
Phone: 920-380-2715    
Michael D Polka, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 920-731-4101    
Cyril Walsh, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 800-968-6866    
Steven J Mcintyre, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 800-968-6866    
Kate Dobberstein,
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2105 E Enterprise Ave Ste 113, Appleton, WI 54913
Phone: 920-216-6171    
Jojo Densel Hammond,
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1506 S Oneida St, Appleton, WI 54915
Phone: 920-738-2100    

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