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

John Raymond Wagner, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1538120704

John Raymond Wagner, MD is an Obstetrics/Gynecology in East Northport, New York. Graduated from Icahn School of Medicine at Mount Sinai in 1987, 39 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
39
Trained at
Icahn School of Medicine at Mount Sinai
Licensed in
NY
In the registry since
2006
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

7 Pulaski Rd
East Northport, NY 11731-2442
Phone: (631) 261-3322
Fax: (631) 368-5440
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 181212 (NY)

Record details

NPI number1538120704
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated 1987 (39 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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