Matthew Wagner, MD
Matthew Wagner, MD is a Pediatric Orthopaedic Surgery Physician in Port Jefferson Station, NY, registered under NPI 1114198751. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 1500 ROUTE 112 BLDG 2C, Port Jefferson Station, NY 11776. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 251727 | NY | Pediatric Orthopaedic Surgery Physician primary |
| ME103612 | FL | Pediatric Orthopaedic Surgery Physician |
Licences are recorded in 2 states: NY, FL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Orthopedic Surgery
- PAC ID
- 2860630498
- Enrollment ID
- I20130521000407
Medicare enrolment is recorded as approved under the provider type Practitioner - Orthopedic Surgery. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Florida and New York. The practice address on file is in Port Jefferson Station, NY, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- ME103612
- Specialty
- Pediatric Orthopaedic Surgery Physician
- Licence
- 251727
- Specialty
- Pediatric Orthopaedic Surgery Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Pediatric Orthopaedic Surgery covers
An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. NUCC Health Care Provider Taxonomy, code 207XP3100X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207XP3100X | Pediatric Orthopaedic Surgery Physician Pediatric Orthopaedic Surgery | 251727 | NY | primary |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician Pediatric Orthopaedic Surgery | ME103612 | FL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1114198751 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 21, 2008 |
| Last updated | Nov 5, 2019 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | MD |
| Practice address |
1500 ROUTE 112 BLDG 2C Port Jefferson Station, NY 11776 (631) 371-8034 Fax (631) 828-7899 |
| Other identifiers |
120130521000407
· Other (NY) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 1 | 4 | 1 | 9 | 8 | 7 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 2 | 4 | 2 | 9 | 7 | 7 | 1 |
Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.