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

Ryan J Wagner

Individual provider Sports Medicine (Emergency Medicine) Physician · NPI 1275087207

Ryan J Wagner practises Sports Medicine in Appleton, Wisconsin. Graduated from Midwestern University, Chicago College of Osteopathic Med in 2014, 12 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
12
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
WI
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

2400 E Capitol Dr
Appleton, WI 54911-8728
Phone: (920) 454-3300
Fax: (920) 531-2098
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 721 E Meadow Grove Blvd, Appleton, WI 54915-4509 — (920) 585-2839

Specialties & licences

Sports Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PS0010X · Licence 68001 (WI)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 68001 (WI)

Record details

NPI number1275087207
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 8, 2016
Last updated in NPPESFebruary 29, 2024
Certification dateFebruary 29, 2024

Medicare enrollment

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

Medicare specialtySPORTS MEDICINE
Also practisesEMERGENCY MEDICINE, ORTHOPEDIC SURGERY
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 2014 (12 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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 patients293
Services billed 3,426 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

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.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Thedacare, Incorporated

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 654 clinicians in the practice; 12 are shown here.

Other providers in Appleton