Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mark Bastian Wagner, MD

Individual provider Specialist · NPI 1891710869

Dr. Mark Bastian Wagner, MD is an Orthopedic Surgery in Tigard, Oregon. Graduated from Temple University School of Medicine in 2001, 25 years ago. Practices with Regenerative Orthopedic Center LLC, a 27-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
25
Trained at
Temple University School of Medicine
Licensed in
OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15755 SW Sequoia Pkwy Ste 200
Tigard, OR 97224-7166
Phone: (503) 639-6002
Fax: (503) 639-1403
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence MD26810 (OR)
Specialist Taxonomy 174400000X · Licence MD26810 (OR)

Record details

NPI number1891710869
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 12, 2006
Last updated in NPPESApril 7, 2015
Mailing address15755 Sw Sequoia Pkwy, Suite 200, Tigard, OR 97224-7166

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolTEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Regenerative Orthopedic Center Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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