Active NPI 1689839177 Individual Practitioner Female Practitioner

Dr. Ida Janelle Wagner , MD

Surgery • Philadelphia, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Ida Wagner, MD is a certified Surgery practicing in Philadelphia, PA. With approximately 21 years of clinical experience since completing medical education in 2005, Dr. Wagner delivers high-quality medical care to the local community at 3509 N BROAD ST.

Dr. Wagner is affiliated with Virtua Medical Group, Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, collagenase, clostridium histolyticum, 0.01 mg, new patient outpatient office visit, injection, triamcinolone acetonide, not otherwise specified, 10 mg. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3509 N Broad St

Philadelphia, PA 191404105

Telephone 2157073933

Fax 2157072531

Associated Practice Facility / Clinic

🏢 Temple University Of The Commonwealth System Of Higher Education Facility NPI 1861480618

Medicare Profile & Education

Medical School

Other

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Philadelphia, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs +0.4 yrs vs City Avg

City Avg: 20.6 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

455 Specialists

Practicing in Philadelphia, PA (1976 Statewide)

Telehealth Adoption Rate

10.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

65.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wagner (21 Years) 21 Yrs

Philadelphia Specialty Average (20.6 Years) 20.6 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
J0775 Injection, collagenase, clostridium histolyticum, 0.01 mg	1,710	13	$122.00	$68.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	148	148	$381.70	$184.14
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	119	70	$4.00	$0.99
73130 X-ray of hand, minimum of 3 views	110	75	$111.00	$41.12
99213 Established patient office or other outpatient visit, typically 15 minutes	104	90	$211.31	$101.56
20550 Injection into tendon or ligament	70	52	$192.50	$60.25
73110 X-ray of wrist, minimum of 3 views	31	27	$125.00	$45.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	22	$299.80	$142.64
20600 Aspiration and/or injection of fluid from small joint	23	20	$173.91	$60.69
73140 X-ray of finger, minimum of 2 views	19	17	$115.00	$43.77
20527 Injection of medication into palm	19	13	$275.00	$83.43
26341 Manipulation of palm pretendinous cord following enzyme injection	19	13	$340.00	$113.74
26055 Incision of tendon covering	17	14	$1920.00	$563.03
64721 Release and/or relocation of hand nerve	17	17	$1437.00	$428.62
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$229.67	$90.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	121	121	$365.00	$178.18
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	114	68	$4.00	$1.04
73130 X-ray of hand, minimum of 3 views	74	54	$110.00	$41.65
99213 Established patient office or other outpatient visit, typically 15 minutes	71	60	$200.00	$97.83
20550 Injection into tendon or ligament	58	43	$220.26	$64.03
73110 X-ray of wrist, minimum of 3 views	43	32	$125.00	$44.39
20600 Aspiration and/or injection of fluid from small joint	26	23	$190.77	$61.24
73140 X-ray of finger, minimum of 2 views	21	18	$115.00	$42.91
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	20	$284.00	$132.99
64721 Release and/or relocation of hand nerve	18	15	$1437.17	$457.26
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$215.00	$88.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$246.00	$122.91
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	46	36	$4.00	$1.15
99213 Established patient office or other outpatient visit, typically 15 minutes	37	28	$200.00	$97.29
73130 X-ray of hand, minimum of 3 views	30	23	$110.00	$42.24
20550 Injection into tendon or ligament	25	22	$224.00	$70.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	17	$125.00	$62.51
73140 X-ray of finger, minimum of 2 views	18	18	$115.00	$43.57
73110 X-ray of wrist, minimum of 3 views	15	11	$125.00	$47.37
20600 Aspiration and/or injection of fluid from small joint	13	13	$172.31	$61.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	17	14	$130.00	$81.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$210.00	$117.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	22	$105.00	$48.49
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	13	$85.00	$42.00
99213 Established patient office or other outpatient visit, typically 15 minutes	18	15	$130.00	$79.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$300.00	$176.21
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$210.00	$116.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	22	$105.00	$45.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$210.00	$111.87
99213 Established patient office or other outpatient visit, typically 15 minutes	12	11	$130.00	$75.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	13	$105.00	$44.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$210.00	$111.44

Medical Specialties & State Licenses

CMS Verified: 2022-08-24

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NJ 25MA11470600

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License PA MD434346

Hospital & Practice Group Affiliations

Virtua Medical Group, Pa

175 Madison Ave, Mount Holly, NJ 080602038

Virtua Medical Group, Pa

200 Bowman Dr, Voorhees, NJ 080439639

Phone: 8562477295

Virtua Medical Group, Pa

100 Bowman Dr, Voorhees, NJ 080439612

Phone: 8562477260

Virtua Medical Group, Pa

1311 Fairview Blvd, Delran, NJ 080751474

Phone: 8567648804

Virtua Medical Group, Pa

3242 Route 206, Bordentown, NJ 085054517

Virtua Medical Group, Pa

100 Bowman Dr, Voorhees, NJ 080439612

Phone: 8562473821

Virtua Medical Group, Pa

90 Brick Rd, Marlton, NJ 080532177

Phone: 8563556000

Virtua Medical Group, Pa

90 Brick Rd, Marlton, NJ 080532177

Phone: 8562477260

Secondary Practice Locations

1311 Fairview Blvd Ste B

Delran, NJ 080751474

Phone: 8567648804

570 Egg Harbor Rd Ste B1

Sewell, NJ 080802359

Phone: 8563418495

200 Bowman Dr Ste E140

Voorhees, NJ 080439631

Phone: 8569834263

Practice Associates & Co-Workers

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

6 Associated Practitioners

Dr. Opeyemi Asanbe , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1134419096

Doctor of Medicine (M.D.)

Dr. James Fox , MD

Plastic Surgery

NPI 1225130537

Doctor of Medicine (M.D.)

Chantelle Rowe , CRNP

Nurse Practitioner

NPI 1356733711

Certified Registered Nurse Practitioner

Dr. Xi Lin Jing , MD

Plastic Surgery

NPI 1538377791

Doctor of Medicine (M.D.)

Dr. Andrew Newman , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1598812216

Doctor of Medicine (M.D.)

Dr. Alireza Hamidian Jahromi , MD

Plastic Surgery

NPI 1639435993

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

13 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 24, 2022

Surgery (License #MD434346 in PA)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 27, 2022

Surgery (License #25MA11470600 in NJ)

✅

NPI Profile Active March 21, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location March 21, 2017

Registered at 3509 N BROAD ST, PHILADELPHIA, PA 191404105 (Tel: 2157073933)

📍

Updated Business Mailing Address March 21, 2017

Registered at 2450 W HUNTING PARK AVE, PHILADELPHIA, PA 191291302 (Tel: 2157073933)

👤

Provider Name / Credentials Updated March 21, 2017

Recorded as IDA WAGNER, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2017

Surgery (License #MD434346 in PA)

✅

NPI Profile Active April 06, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location April 06, 2009

Registered at 2601 HOLME AVE, PHILADELPHIA, PA 191522007 (Tel: 2673507417)

📍

Updated Business Mailing Address April 06, 2009

Registered at 3401 N BROAD ST, PHILADELPHIA, PA 191405103 (Tel: 2157077032)

👤

Provider Name / Credentials Updated April 06, 2009

Recorded as IDA WAGNER, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2009

Surgery (License #MD434346 in PA)

🟢

Initial NPI Registration & Enumeration July 23, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1689839177

Entity Type:

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

Enumeration Date: July 23, 2008

Last Update: August 24, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2450 W Hunting Park Ave

Philadelphia, PA 191291302

Phone: 2157073933

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

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.