ANDREW A WAGNER (NPI# 1699722082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699722082 |
| Entity Type | Individual |
| Full Name | ANDREW A WAGNER |
| Credential | M.D. |
| Practice Address |
Rabb 440 Beth Israel Deaconess Medical Center Boston MA 02215-0000 |
| Mailing Address |
330 Brookline Avenue Rabb 440 Boston MA 02215 |
| Practice Telephone | 6176672898 |
| Practice Fax Number | 6176672897 |
| Mailing Telephone | 6176672898 |
| Mailing Fax Number | 6176672897 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2009-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 227569 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 2117401 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780198416 | Andrew Howard Wagner | Physical Therapist | 120 Briggswood Dr, Elma, NY 14059-9477 | 2017-11-16 |
| 1568860401 | Andrew Anthony Wagner | Chiropractor | 103 N Choteau Ave, Hardin, MT 59034-2111 | 2014-12-09 |
| 1992072151 | Andrew Wagner | Pharmacist | 4295 County Road 12, Lafayette, AL 36862-5209 | 2011-11-16 |
| 1427130814 | Andrew Thomas Wagner | Physical Therapist | 10205 Hickory Valley Dr, Fort Wayne, IN 46835-9558 | 2006-10-19 |
| 1285722819 | Andrew Stephen Wagner | Family Medicine | 819 Longwood Ln, Sebastopol, CA 95472-2734 | 2006-10-10 |
| 1306802087 | Andrew Blake Wagner | Physical Therapist | 7701 West Kilgore, Ste 1a, Yorktown, IN 47396 | 2006-04-22 |
| 1619511623 | Andrew Wagner | Pharmacist | 302 Valley Hi Dr, San Antonio, TX 78227-4602 | 2019-11-01 |
| 1861058315 | Andrew John Wagner | Audiologist | 3170 N Federal Hwy Ste 115, Lighthouse Point, FL 33064-6786 | 2019-05-09 |
| 1861978819 | Andrew Wagner | Nurse Anesthetist, Certified Registered | 2823 Fresno St, Fresno, CA 93721-1324 | 2018-07-12 |
| 1821584830 | Andrew J Wagner | Pharmacist | 311 W Broadway St, Eagle Grove, IA 50533-1711 | 2018-07-03 |
| Street Address |
RABB 440 BETH ISRAEL DEACONESS MEDICAL CENTER |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952796518 | Filipe La Fuente De Carvalho | Urology | 55 Fruit St Dept of Urology, Boston, MA 02114-2621 | 2015-03-31 |
| 1083955538 | Eugene Blanchard Cone | Urology | 55 Fruit St - Grb 1100, Massachusetts General Hospital - Department of Urology, Boston, MA 02114 | 2013-03-08 |
| 1861780983 | Mark Arthur Preston | Urology | 36 Hancock St, Apt 5b, Boston, MA 02114-4117 | 2011-07-11 |
| 1841589132 | Dimitar Zlatev | Urology | 55 Fruit St # 1102, Boston, MA 02114-2621 | 2011-04-07 |
| 1275733867 | Peter Chang | Urology | 330 Brookline Ave # Rabb440, Boston, MA 02215-5400 | 2007-07-20 |
| 1659576189 | Jairam R Eswara | Urology | 45 Francis Street, Asb-iii, Brigham and Women's Hospital, Division of Urology, Boston, MA 02115-6105 | 2007-06-15 |
| 1699855619 | Elise De | Urology | 165 Cambridge St Fl 7, Boston, MA 02114-2783 | 2006-10-16 |
| 1295769958 | Carlos R Estrada Jr. | Urology | Children's Hospital, Hu390, 300 Longwood Avenue, Dept. of Urology, Boston, MA 02115 | 2006-07-10 |
| 1891733101 | Anurag K Das | Urology | 330 Brookline Ave., Urology, Beth Israel Deaconess Medical Center, Boston, MA 02215 | 2006-06-02 |
| 1396797619 | Jerome Paul Richie | Urology | 45 Francis Street Asbii 3, Brigham and Womens Hospital Division of Urology, Boston, MA 02115 | 2006-05-16 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.