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

Mr. Jeffrey Douglas Wagner, PA

Individual provider Medical Physician Assistant · NPI 1891744967

Mr. Jeffrey Douglas Wagner, PA is a Physician Assistant in Sayville, New York. Graduated from Columbia University College of Physicians and Surgeons in 2003, 23 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment.

Years since qualifying
23
Trained at
Columbia University College of Physicians and Surgeons
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

18 Ronald Ln
Sayville, NY 11782-1622
Phone: (631) 750-3924
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1891744967
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 8, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolCOLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduated 2003 (23 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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