Mark Wagoner, MD
NPI 1669177341 · Student in an Organized Health Care Education/Training Program · Phoenix, AZ
Enrolled with Medicare as Order and Referring Only - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mark Wagoner, MD is a Student in an Organized Health Care Education/Training Program provider in Phoenix, AZ (NPI 1669177341).
Provider details
- NPI number
- 1669177341
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 811 S Hamilton StChandler, AZ 85225-6308Phone: (480) 344-6100Fax: (602) 655-9614
Registry dates
- Enumerated
- 2023-04-03
- Last updated
- 2023-04-18
- Certified
- 2023-04-18
Frequently asked questions
- What is Mark Wagoner's NPI number?
- Mark Wagoner's National Provider Identifier (NPI) is 1669177341, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Wagoner's specialty?
- Mark Wagoner is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Mark Wagoner located?
- Mark Wagoner's practice location on file with NPPES is 350 W Thomas Rd, Phoenix, AZ 85013-4496.
- What is Mark Wagoner's phone number?
- The practice phone number listed in the NPPES registry for Mark Wagoner is (602) 406-3000.
- Does Mark Wagoner accept Medicare?
- Mark Wagoner is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mark Wagoner's NPI active?
- Yes — Mark Wagoner's NPI (1669177341) is active in the NPPES registry as of the last update on 2023-04-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.