Active NPI 1285899401 Individual Practitioner Male Practitioner

Dr. Austin J Wagner , DO

Surgery - Vascular Surgery • Lees Summit, MO

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Austin Wagner, DO is a certified Surgery - Vascular Surgery practicing in Lees Summit, MO. With approximately 18 years of clinical experience since graduating from Kansas City University Of Med & Biosciences, College Of Osteo Med in 2008, Dr. Wagner delivers high-quality medical care to the local community at 3600 NE RALPH POWELL RD STE D.

Dr. Wagner maintains professional affiliations with Restore Muscle And Joint Llc, Midwest Aortic And Vascular Institute Pc, Sage Medical Prof Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, ultrasound study of arm and leg arteries, ultrasound of leg arteries or artery grafts. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3600 Ne Ralph Powell Rd Ste D

Lees Summit, MO 640642369

Telephone 8166750920

Associated Practice Facility / Clinic

🏢 Foot Specialists Of Kansas City, Pa Facility NPI 1760329726

Medicare Profile & Education

Medical School

Kansas City University Of Med & Biosciences, College Of Osteo Med

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Vascular Surgery in Lees Summit, MO

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

18 Yrs -0.3 yrs vs City Avg

City Avg: 18.3 Yrs

State Avg: 29.2 Yrs

Regional Practice Density

3 Specialists

Practicing in Lees Summit, MO (105 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wagner (18 Years) 18 Yrs

Lees Summit Specialty Average (18.3 Years) 18.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	136	$264.45	$126.55
93922 Ultrasound study of arm and leg arteries	146	106	$216.92	$78.30
93925 Ultrasound of leg arteries or artery grafts	140	102	$463.20	$231.20
93880 Ultrasound of both sides of head and neck blood flow	135	128	$465.87	$184.90
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	102	97	$341.52	$125.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	85	85	$407.27	$162.83
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	72	69	$466.02	$175.34
93970 Ultrasound study of arm or leg veins with compression and maneuvers	70	70	$452.60	$177.27
99213 Established patient office or other outpatient visit, typically 15 minutes	33	33	$176.18	$89.10
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	33	28	$356.87	$174.77
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	28	24	$179.55	$78.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$266.12	$106.49
76937 Ultrasonic guidance for blood vessel access	18	18	$36.35	$13.14
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	17	16	$580.17	$83.49
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	16	16	$47.85	$16.89
36565 Insertion of central venous catheters for infusion, two catheters in two veins	16	16	$2402.80	$296.40
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	14	11	$510.17	$257.72
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	13	11	$294.55	$116.13
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$511.43	$220.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93922 Ultrasound study of arm and leg arteries	172	103	$216.92	$77.69
93925 Ultrasound of leg arteries or artery grafts	165	99	$463.20	$226.41
93880 Ultrasound of both sides of head and neck blood flow	149	141	$465.87	$182.23
93970 Ultrasound study of arm or leg veins with compression and maneuvers	87	85	$452.60	$179.36
99213 Established patient office or other outpatient visit, typically 15 minutes	82	78	$179.32	$85.57
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	78	77	$466.02	$173.40
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	74	70	$341.52	$120.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	71	64	$264.45	$123.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$266.12	$107.77
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	60	60	$407.27	$159.16
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	34	$179.55	$74.93
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	33	32	$356.87	$173.32
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	24	16	$294.55	$114.53
36565 Insertion of central venous catheters for infusion, two catheters in two veins	16	16	$2402.80	$303.67
76937 Ultrasonic guidance for blood vessel access	16	16	$36.35	$13.82
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	15	15	$47.85	$17.45
75625 Radiological supervision and interpretation X-ray of abdominal aorta	14	14	$141.25	$65.20
93970 Ultrasound study of arm or leg veins with compression and maneuvers	12	12	$75.00	$32.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93922 Ultrasound study of arm and leg arteries	170	118	$216.92	$79.50
93925 Ultrasound of leg arteries or artery grafts	165	115	$463.20	$238.15
93880 Ultrasound of both sides of head and neck blood flow	134	129	$465.87	$188.37
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	123	111	$341.52	$129.84
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	113	79	$179.55	$67.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	108	108	$266.12	$106.95
99213 Established patient office or other outpatient visit, typically 15 minutes	101	91	$179.32	$88.00
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	67	64	$466.02	$176.48
93970 Ultrasound study of arm or leg veins with compression and maneuvers	61	60	$452.60	$183.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	30	$264.45	$121.22
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	25	11	$3078.65	$1140.84
99218 Hospital observation care typically 30 minutes	24	23	$248.67	$95.19
76937 Ultrasonic guidance for blood vessel access	20	13	$77.25	$36.70
75625 Radiological supervision and interpretation X-ray of abdominal aorta	17	17	$141.25	$67.23
99231 Follow-up hospital inpatient care per day, typically 15 minutes	16	16	$98.25	$37.56
76937 Ultrasonic guidance for blood vessel access	12	11	$36.35	$13.51
36565 Insertion of central venous catheters for infusion, two catheters in two veins	12	11	$2402.80	$317.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93925 Ultrasound of leg arteries or artery grafts	186	133	$463.20	$248.24
93922 Ultrasound study of arm and leg arteries	186	129	$216.92	$82.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	138	138	$266.12	$110.15
93880 Ultrasound of both sides of head and neck blood flow	121	114	$465.87	$195.45
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	119	114	$341.52	$132.66
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	112	76	$179.55	$70.39
99213 Established patient office or other outpatient visit, typically 15 minutes	105	104	$179.32	$89.10
93970 Ultrasound study of arm or leg veins with compression and maneuvers	70	70	$452.60	$193.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	53	$264.45	$128.72
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	52	49	$466.02	$183.28
99218 Hospital observation care typically 30 minutes	44	43	$248.67	$92.72
99231 Follow-up hospital inpatient care per day, typically 15 minutes	39	37	$98.25	$37.96
76937 Ultrasonic guidance for blood vessel access	35	29	$36.35	$13.83
36565 Insertion of central venous catheters for infusion, two catheters in two veins	29	26	$2402.80	$319.40
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	22	13	$3078.65	$1261.80
99224 Subsequent observation care, typically 15 minutes per day	21	14	$99.10	$28.71
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	21	21	$47.85	$18.61
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$407.27	$166.80
75625 Radiological supervision and interpretation X-ray of abdominal aorta	19	18	$141.25	$68.55
11042 Removal of skin and tissue, 20.0 sq cm or less	15	13	$286.32	$40.93
36589 Removal of central venous catheter for infusion	14	14	$415.02	$162.34
76536 Ultrasound of head and neck	13	13	$70.77	$27.95
35301 Removal of blood clot and portion of artery of neck	13	13	$2977.87	$1127.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	148	140	$341.52	$137.72
99213 Established patient office or other outpatient visit, typically 15 minutes	105	101	$179.32	$73.06
93922 Ultrasound study of arm and leg arteries	102	71	$216.92	$81.57
93925 Ultrasound of leg arteries or artery grafts	91	64	$463.20	$246.08
93880 Ultrasound of both sides of head and neck blood flow	85	81	$465.87	$198.01
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	73	73	$266.12	$106.52
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	66	55	$179.55	$70.92
99218 Hospital observation care typically 30 minutes	43	40	$248.67	$101.25
76937 Ultrasonic guidance for blood vessel access	41	34	$36.35	$14.79
99231 Follow-up hospital inpatient care per day, typically 15 minutes	40	33	$98.25	$39.89
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	39	31	$466.02	$182.97
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	30	24	$47.85	$19.11
36565 Insertion of central venous catheters for infusion, two catheters in two veins	30	24	$2402.80	$338.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	29	$264.45	$105.72
75625 Radiological supervision and interpretation X-ray of abdominal aorta	21	21	$141.25	$71.57
93990 Ultrasound of dialysis access	20	17	$281.37	$134.31
99224 Subsequent observation care, typically 15 minutes per day	15	13	$99.10	$40.20
76536 Ultrasound of head and neck	14	14	$70.77	$28.56
35301 Removal of blood clot and portion of artery of neck	14	14	$2977.87	$1175.22
93970 Ultrasound study of arm or leg veins with compression and maneuvers	13	13	$452.60	$193.07
11042 Removal of skin and tissue, 20.0 sq cm or less	13	12	$286.32	$53.19
36821 Relocation of arm vein with connection to arm artery, open procedure	11	11	$1742.77	$693.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	173	164	$341.52	$137.19
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	109	81	$179.55	$71.47
99213 Established patient office or other outpatient visit, typically 15 minutes	107	99	$179.32	$71.90
93922 Ultrasound study of arm and leg arteries	101	83	$216.92	$81.50
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	91	91	$266.12	$105.80
99231 Follow-up hospital inpatient care per day, typically 15 minutes	72	56	$98.25	$39.46
93925 Ultrasound of leg arteries or artery grafts	68	58	$463.20	$238.36
11042 Removal of skin and tissue, 20.0 sq cm or less	65	24	$286.32	$58.97
93880 Ultrasound of both sides of head and neck blood flow	63	60	$465.87	$197.81
99213 Established patient office or other outpatient visit, typically 15 minutes	55	41	$130.68	$50.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	30	$264.45	$104.14
93926 Ultrasound of one leg arteries or artery grafts	29	25	$374.15	$132.23
75625 Radiological supervision and interpretation X-ray of abdominal aorta	27	26	$153.99	$56.39
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	25	23	$466.02	$185.42
76937 Ultrasonic guidance for blood vessel access	20	18	$36.35	$14.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	16	$85.55	$25.26
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	16	15	$47.85	$18.87
99218 Hospital observation care typically 30 minutes	16	15	$248.67	$100.02
36565 Insertion of central venous catheters for infusion, two catheters in two veins	16	15	$2402.80	$311.84
93990 Ultrasound of dialysis access	16	14	$281.37	$132.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$126.34	$67.82
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	14	13	$3078.65	$204.84
37224 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure	14	13	$8825.25	$247.55
37228 Balloon dilation of artery of leg, initial vessel	13	12	$13298.67	$501.98
36821 Relocation of arm vein with connection to arm artery, open procedure	13	13	$1742.77	$689.39
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	12	11	$3078.65	$1043.17
75625 Radiological supervision and interpretation X-ray of abdominal aorta	11	11	$339.00	$130.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	134	125	$341.94	$135.51
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	91	70	$179.55	$72.48
11042 Removal of skin and tissue, 20.0 sq cm or less	87	33	$284.57	$59.65
99213 Established patient office or other outpatient visit, typically 15 minutes	84	74	$179.32	$71.46
99231 Follow-up hospital inpatient care per day, typically 15 minutes	64	52	$98.25	$38.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$266.12	$105.04
99213 Established patient office or other outpatient visit, typically 15 minutes	56	41	$127.90	$50.38
93922 Ultrasound study of arm and leg arteries	53	47	$216.92	$86.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	41	$264.45	$106.14
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	45	43	$44.00	$22.61
93880 Ultrasound of both sides of head and neck blood flow	42	40	$465.87	$199.72
93970 Ultrasound study of arm or leg veins with compression and maneuvers	30	28	$75.00	$34.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$113.33	$65.50
93923 Complete ultrasound study of arm and leg arteries	25	23	$338.12	$133.87
93926 Ultrasound of one leg arteries or artery grafts	24	19	$374.15	$132.94
93990 Ultrasound of dialysis access	23	20	$281.37	$128.43
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	21	17	$2394.08	$233.01
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	20	18	$35.25	$14.32
35301 Removal of blood clot and portion of artery of neck	19	18	$2954.14	$1166.71
93880 Ultrasound of both sides of head and neck blood flow	19	19	$85.00	$40.35
76536 Ultrasound of head and neck	19	18	$70.20	$28.14
93923 Complete ultrasound study of arm and leg arteries	18	18	$48.00	$22.28
93925 Ultrasound of leg arteries or artery grafts	18	17	$463.20	$255.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	15	$90.42	$25.20
75625 Radiological supervision and interpretation X-ray of abdominal aorta	16	15	$141.25	$56.27
37224 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure	15	15	$9366.30	$284.26
37228 Balloon dilation of artery of leg, initial vessel	15	14	$13298.67	$489.26
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	14	13	$466.02	$188.81
36821 Relocation of arm vein with connection to arm artery, open procedure	13	11	$1742.77	$632.86
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	13	13	$45.43	$18.70
36830 Connection of tube graft to vein and artery for dialysis	12	12	$1753.75	$688.24
36832 Revision of dialysis graft, open procedure	12	11	$1963.16	$771.12
36565 Insertion of central venous catheters for infusion, two catheters in two veins	12	12	$1993.35	$271.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$407.27	$162.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	119	110	$341.52	$134.38
99213 Established patient office or other outpatient visit, typically 15 minutes	100	85	$179.32	$69.65
11042 Removal of skin and tissue, 20.0 sq cm or less	92	29	$285.08	$61.45
99213 Established patient office or other outpatient visit, typically 15 minutes	67	51	$115.35	$50.20
99231 Follow-up hospital inpatient care per day, typically 15 minutes	55	46	$98.25	$38.16
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	54	50	$44.00	$22.09
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	37	$179.55	$71.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	46	46	$266.12	$104.37
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	46	13	$100.48	$26.34
93970 Ultrasound study of arm or leg veins with compression and maneuvers	41	41	$75.00	$34.73
93923 Complete ultrasound study of arm and leg arteries	36	33	$338.12	$133.04
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	29	26	$2550.30	$191.77
93922 Ultrasound study of arm and leg arteries	28	25	$216.92	$79.97
75625 Radiological supervision and interpretation X-ray of abdominal aorta	27	26	$140.54	$54.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	19	$87.98	$25.20
36821 Relocation of arm vein with connection to arm artery, open procedure	26	25	$1682.36	$651.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	23	$264.45	$105.05
93880 Ultrasound of both sides of head and neck blood flow	25	25	$85.00	$39.98
93880 Ultrasound of both sides of head and neck blood flow	24	21	$465.87	$185.77
37224 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure	23	22	$7914.25	$409.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$174.49	$75.02
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	19	16	$44.96	$18.93
36832 Revision of dialysis graft, open procedure	16	15	$1950.65	$772.44
93925 Ultrasound of leg arteries or artery grafts	15	13	$463.20	$219.90
76937 Ultrasonic guidance for blood vessel access	13	13	$34.68	$13.51
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	13	11	$35.25	$14.23
36565 Insertion of central venous catheters for infusion, two catheters in two veins	13	12	$1772.88	$309.34
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	11	11	$142.40	$56.24

Medical Specialties & State Licenses

CMS Verified: 2025-09-23

Surgery - Vascular Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0129X

State License MO 2015007378

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Surgery - Vascular Surgery

NUCC Taxonomy Code: 2086S0129X

State License KS 05-41644

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Hospital & Practice Group Affiliations

Sage Medical Prof Llc

3600 Ne Ralph Powell Rd, Lees Summit, MO 640642369

Phone: 8166470555

Vascular And Interventional Radiology Of Siouxland

3600 Ne Ralph Powell Rd, Lees Summit, MO 640642369

Phone: 8166750920

Shawnee Mission Medical Center Inc

9100 W 74th St, Merriam, KS 662044004

Phone: 9136762000

Vascular And Interventional Radiology Of Siouxland

824 W Frontier Ln, Olathe, KS 660617216

Phone: 8166750920

Sage Medical Prof Llc

824 W Frontier Ln, Olathe, KS 660617216

Phone: 8166470555

Restore Muscle And Joint Llc

4119 Nw Barry Rd, Kansas City, MO 641541100

Phone: 8164524488

Midwest Aortic And Vascular Institute Pc

4200 Little Blue Pkwy, Independence, MO 640578320

Phone: 8168425555

Secondary Practice Locations

824 W Frontier Ln

Olathe, KS 660617216

Phone: 8166750920

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Letraya Nielsen , FNP-C

Nurse Practitioner - Family

NPI 1477313914

Family Nurse Practitioner (Certified)

Dr. David Mantilla , MD

Surgery - Vascular Surgery

NPI 1598252835

Doctor of Medicine (M.D.)

Amanda Sandor , APRN, FNP-BC

Nurse Practitioner

NPI 1891386769

Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Dr. Richard Coats , MD

Surgery - Vascular Surgery

NPI 1972507705

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location September 23, 2025

Registered at 3600 NE RALPH POWELL RD STE D, LEES SUMMIT, MO 640642369 (Tel: 8166750920)

📍

Updated Business Mailing Address September 23, 2025

Registered at 3600 NE RALPH POWELL RD STE D, LEES SUMMIT, MO 640642369 (Tel: 8166750920)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2025

Surgery (License #05-41644 in KS)

✅

NPI Profile Active May 16, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location May 16, 2016

Registered at 2750 CLAY EDWARDS DR, SUITE 304, NORTH KANSAS CITY, MO 641163237 (Tel: 8168425555)

📍

Updated Business Mailing Address May 16, 2016

Registered at 2750 CLAY EDWARDS DR, SUITE 304, NORTH KANSAS CITY, MO 641163237 (Tel: 8168425555)

👤

Provider Name / Credentials Updated May 16, 2016

Recorded as AUSTIN WAGNER, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 16, 2016

Surgery (License #OT013004 in PA)

🟢

Initial NPI Registration & Enumeration July 28, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285899401

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 28, 2008

Last Update: September 23, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

3600 Ne Ralph Powell Rd Ste D

Lees Summit, MO 640642369

Phone: 8166750920

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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