Ida J Wagner (NPI# 1689839177, PAC ID# 8921176082) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1689839177 |
| PAC ID by PECOS | 8921176082 |
| Professional Enrollment ID | I20081003000041 |
| Full Name | Ida J Wagner |
| Organization Legal Name | TEMPLE FACULTY PRACTICE PLAN INC |
| Address |
7500 Central Ave Philadelphia PA 19111-2430 |
| Phone Number | 2157077200 |
| Gender | F |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 2005 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 0345588711 |
| Number of Group Practice Members | 724 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390027 | TEMPLE UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3401 N Broad St, Philadelphia, PA 19140-5103 | 2157075030 | TEMPLE FACULTY PRACTICE PLAN INC |
| 7500 Central Ave, Philadelphia, PA 19111-2430 | 2157077200 | TEMPLE FACULTY PRACTICE PLAN INC |
| Organization Legal Name | TEMPLE FACULTY PRACTICE PLAN INC |
| Physicians | 711 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin Michael Gamez | Obstetrics/gynecology | Temple Faculty Practice Plan Inc | 515 Pennsylvania Ave, Fort Washington, PA 19034-3314 |
| Hiu Ying Joanna Choi | Family Medicine | Temple Faculty Practice Plan Inc | 1316 W Ontario St, Philadelphia, PA 19140-5220 |
| Evan Carabelli | Internal Medicine | Temple Faculty Practice Plan Inc | 3223 N Broad St, Philadelphia, PA 19140-5007 |
| Cecelia Elizabeth Schmalbach | Otolaryngology | Temple Faculty Practice Plan Inc | 1077 Rydal Rd, Meadowbrook, PA 19046-1712 |
| Brianna Elizabeth Reardon | Nurse Practitioner | Temple Faculty Practice Plan Inc | 7604 Central Ave, Philadelphia, PA 19111-2433 |
| Sarah Fenerty | Diagnostic Radiology | Temple Faculty Practice Plan Inc | 2301 E Allegheny Ave, Philadelphia, PA 19134-4427 |
| Ben Hur Mobo | Family Medicine | Temple Faculty Practice Plan Inc | 1700 N Broad St, Philadelphia, PA 19121-3429 |
| Elizabeth Diane Dauer | General Surgery | Temple Faculty Practice Plan Inc | 701 Ostrum St, Fountain Hill, PA 18015-1155 |
| Maria Escorcia De Leon | Internal Medicine | Temple Faculty Practice Plan Inc | 3401 N Broad St, Philadelphia, PA 19140-5103 |
| Matthew Simon | Emergency Medicine | Temple Faculty Practice Plan Inc | 7600 Central Ave, Philadelphia, PA 19111-2442 |
| Street Address |
7500 CENTRAL AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip | 19111-2430 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bong-soo Kim | Neurosurgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Mark Krakauer | Ophthalmology | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Yi Zhang | Ophthalmology | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Roh Yanagida | Thoracic Surgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Charles Bakhos | Thoracic Surgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Christopher Loftus | Neurosurgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Doreen Rustam | Nurse Practitioner | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Kenji Minakata | Thoracic Surgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Michael S Fakhraee | Plastic and Reconstructive Surgery | 7500 Central Ave, Suite 101, Philadelphia, PA 19111-2431 | |
| Stacey Herbert Brann | Thoracic Surgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linda A Petti | Psychologist, Clinical | 535 Penny Ln, Philadelphia, PA 19111-1201 | |
| Brenda A Buzydlowski | Hospice/palliative Care | Hr Physician Services | 8580 Verree Rd, Philadelphia, PA 19111-1370 |
| Arelyne B Pacho | Physical Medicine and Rehabilitation | 8015 Lawndale Ave, Philadelphia, PA 19111-1507 | |
| Donna R Farrell | Family Practice | Montgomery County Medical Associates, Ltd. | 8014 Burholme Ave, Philadelphia, PA 19111-1801 |
| Catherine E Canty | Chiropractic | 8012 Pine Rd, Fl 1, Philadelphia, PA 19111-1809 | |
| Uriel Schechter | Optometry | 7834 Oxford Ave, Philadelphia, PA 19111-2219 | |
| Stacy W Lexow | Obstetrics/gynecology | Abington Memorial Hospital | 7996 Oxford Ave, Philadelphia, PA 19111-2241 |
| Mary T Greybush | Obstetrics/gynecology | Abington Memorial Hospital | 7996 Oxford Ave, Philadelphia, PA 19111-2241 |
| Phyllis M Briggs | Nurse Practitioner | Abington Memorial Hospital | 7996 Oxford Ave, Philadelphia, PA 19111-2241 |
| Gengo Sunagawa | Thoracic Surgery | Temple Faculty Practice Plan Inc | 7500 Central Ave, Philadelphia, PA 19111-2430 |
| Find all physicians in zip 19111 | |||
| City | PHILADELPHIA |
| Zip Code | 19111 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | PHILADELPHIA + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Ida J Wagner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.