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

Serena Wagoner, DO

Individual provider Child Abuse Pediatrics Physician · NPI 1790314854

Serena Wagoner, DO is a Pediatric Medicine in Beaver Dam, Wisconsin. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

705 S University Ave
Beaver Dam, WI 53916-3053
Phone: (920) 887-9272
Show map & directions

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

Specialties & licences

Child Abuse Pediatrics Physician (primary) Taxonomy 2080C0008X · Licence 82110 (WI)

Record details

NPI number1790314854
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 2, 2020
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026
Mailing address7974 Uw Health Ct, Middleton, WI 53562-5531

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare