Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Andrew Wagner

Individual provider Social Worker · NPI 1073900320

Andrew Wagner is registered under Occupational Therapist in Private Practice in Gresham, Oregon. Qualified in 2019, 7 years ago. Practices with Sportscare Physical Therapy @ Cornell, LLC, a 35-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
7
Licensed in
OR
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone: (503) 674-7860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hand Occupational Therapist (primary) Taxonomy 225XH1200X · Licence 423249 (OR)
Social Worker Taxonomy 104100000X (OR)

Record details

NPI number1073900320
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 23, 2015
Last updated in NPPESNovember 29, 2022
Certification dateNovember 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sportscare Physical Therapy @ Cornell, Llc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients51
Services billed 786 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Sportscare Physical Therapy @ Cornell, LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 35 clinicians in the practice; 12 are shown here.

Other providers in Gresham