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Matthew Wagner

Male

Medical Specialty

Diagnostic Radiology

Professional ID

NPI: 1144219403
PECOS ID: 2961470653
Enrollment ID: I20040921000351
Credential(MD, DO, DPM): MD
Medical School: Ohio State University College Of Medicine
Medical School Graduation Year: 1996

Hospital Service

Hospital CCN1: 360035
Business Name (LBN)1: Mount Carmel West
Hospital CCN2: 360355
Business Name (LBN)2: Ohio Valley Medical Center, Llc
Hospital CCN3: 360012
Business Name (LBN)3: Mount Carmel St Anns
Hospital CCN4: 360266
Business Name (LBN)4: Mount Carmel New Albany Surgical Hospital
Hospital CCN5: 360358
Business Name (LBN)5: Diley Ridge Medical Center

Medical Practices

Organization Name: Radiology Incorporated
Group Practice ID assigned by PECOS: 1658274543
Number of Group Practice member: 56

Location

Address1: 10567 Sawmill Pkwy
Address2:
City: Powell
State: Ohio
Zip Code: 43065
Phone Number: (614)717-9840

Location

Address1: 11925 Lithopolis Rd Nw
Address2:
City: Canal Winchester
State: Ohio
Zip Code: 43110
Phone Number: (614)837-6363

Location

Address1: 140 W Main St
Address2:
City: Springfield
State: Ohio
Zip Code: 45502
Phone Number: (937)521-4940

Location

Address1: 4030 W Henderson Rd
Address2:
City: Columbus
State: Ohio
Zip Code: 43220
Phone Number: (614)442-7550

Location

Address1: 4191 Kelnor Dr
Address2: Suite 100
City: Grove City
State: Ohio
Zip Code: 43123
Phone Number: (614)875-6004

Location

Address1: 4885 Olentangy River Rd
Address2: Suite 150
City: Columbus
State: Ohio
Zip Code: 43214
Phone Number: (614)326-2672

Location

Address1: 500 S Cleveland Ave
Address2:
City: Westerville
State: Ohio
Zip Code: 43081
Phone Number: (614)898-8378

Location

Address1: 6001 E Broad St
Address2:
City: Columbus
State: Ohio
Zip Code: 43213
Phone Number: (614)234-6770

Location

Address1: 6201 Gender Rd
Address2:
City: Canal Winchester
State: Ohio
Zip Code: 43110
Phone Number: (614)834-8042

Location

Address1: 6488 E Main St
Address2: Suite 100
City: Reynoldsburg
State: Ohio
Zip Code: 43068
Phone Number: (614)326-2672

Location

Address1: 793 W State St
Address2:
City: Columbus
State: Ohio
Zip Code: 43222
Phone Number: (614)234-5100

Medicare

Medicare Assignment: Yes
Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
Used Electronic health record (EHR):